Individual provider Active NPI

Louis D Kitsko, MPAS, PA-C

  • Surgical Physician Assistant
  • Johnstown, PA
National Provider Identifier
1699963975
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA003383L Issued in PA
Practice address
1400 Murphy Dr
Johnstown, PA 15905-1529
Phone
(814) 255-2102
NPI assigned
Oct 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA003383L PA Primary

Addresses

Primary practice location

1400 Murphy Dr
Johnstown, PA 15905-1529

Mailing address

1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 535-9407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090414000027 PA Practitioner - Physician Assistant 4789731548 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cambria Somerset Radiology and Nuclear Medicine Group IncGroup PAC ID 7113824277, 38 clinicians

Practice addresses (Care Compare)

105 Nason Dr
Roaring Spring, PA 16673-1202
Phone (814) 535-4065

1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 536-7226

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA003383LPAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group of Pennsylvania PC CurrentSince Nov 1, 2015 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Sep 1, 2014 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Sep 1, 2014 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

236 Jamesway Rd
Ebensburg, PA 15931
Phone (814) 471-6595

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1699963975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-535-9407",
            "fax_number": "814-534-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MURPHY DR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159051529",
            "telephone_number": "814-255-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITSKO",
        "first_name": "LOUIS",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA003383L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.