NPIMap

Individual provider Active NPI

Kristinia Maciunas, M.D.

  • Family Medicine Physician
  • Shepherdstown, WV
National Provider Identifier
1669474755
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14514 Issued in WV
Practice address
207 South Princess Street
Shepherdstown, WV 25443
Phone
(304) 261-0313
NPI assigned
Jun 2, 2005
Last updated
Apr 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14514 WV Primary

Addresses

Primary practice location

207 South Princess Street
Shepherdstown, WV 25443

Mailing address

PO Box 1683
Shepherdstown, WV 25443-1683
Phone (304) 261-0313

Other identifiers 1

IdentifierTypeStateIssuer
0045551000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051006000075 WV Practitioner - Family Practice 6608891932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians
Healing Ways Healthcare PLLCGroup PAC ID 3779895818, 3 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

207 S Princess St
Suite 12
Shepherdstown, WV 25443-1581
Phone (304) 261-0313

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14514WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Ways Healthcare, PLLC CurrentSince Apr 1, 2015 Accepting new patients
Shenandoah Valley Medical System, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Shenandoah Valley Medical System, Inc. Past Accepting new patients
Shenandoah Valley Family Health Center Family Medicine Past Accepting new patients

Locations

207 S Princess St
Ste 11
Shepherdstown, WV 25443
Phone (304) 579-4746

207 S Princess St
Ste 12
Shepherdstown, WV 25443
Phone (304) 261-0313

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kristina.maciunas@347753799614468.direct.elationemr.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1669474755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1683",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "254431683",
            "telephone_number": "304-261-0313",
            "fax_number": "304-876-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 SOUTH PRINCESS STREET",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "25443",
            "telephone_number": "304-261-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIUNAS",
        "first_name": "KRISTINIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-02",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "14514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0045551000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shepherdstown, WV

Sources for this page

Verify at the official NPI Registry.