NPIMap

Individual provider Active NPI

Kathleen M Wasylik, MD

  • Pediatric Otolaryngology Physician
  • St Petersburg, FL
National Provider Identifier
1669573028
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
ME98034 Issued in FL
Practice address
601 5TH St. South
#701
St Petersburg, FL 33701
Phone
(727) 329-5400
Fax
(727) 329-5402
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 48414 MN
Pediatric Otolaryngology Physician 207YP0228X ME98034 FL Primary

Addresses

Primary practice location

601 5TH St. South
#701
St Petersburg, FL 33701

Mailing address

PO Box 76479
St Petersburg, FL 33734
Phone (727) 329-5400

Other identifiers 1

IdentifierTypeStateIssuer
787267400MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME98034FLMDPediatric Otolaryngology Physician
48414MNMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Pediatric Otolaryngology Head and Neck Surgeyr Assoc. PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kwasylik188763@orlandohealth.medalliesdirect.net
  • Direct secure messaging: kwasylik735013@direct.hopkinsmedicine.org

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1669573028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 76479",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33734",
            "telephone_number": "727-329-5400",
            "fax_number": "727-329-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH ST. SOUTH",
            "address_2": "#701",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33701",
            "telephone_number": "727-329-5400",
            "fax_number": "727-329-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASYLIK",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MN",
            "license": "48414",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "FL",
            "license": "ME98034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "787267400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.