Individual provider Active NPI

Kristin V Kowalchik, MD

  • Radiation Oncology Physician
  • Winchester, VA
National Provider Identifier
1710130828
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
0101258428 Issued in VA
Practice address
400 Campus Blvd Ste 110
Winchester, VA 22601
Phone
(540) 662-1108
Fax
(450) 540-2244
NPI assigned
Nov 3, 2008
Last updated
May 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 0101258428 VA Primary

Addresses

Primary practice location

400 Campus Blvd Ste 110
Winchester, VA 22601

Mailing address

400 Campus Blvd Ste 100
Winchester, VA 22601-6906
Phone (540) 662-1108

Other practice location 1

400 Campus Blvd Ste 100
Winchester, VA 22601
Phone (540) 662-1108

Other identifiers 1

IdentifierTypeStateIssuer
1710130828MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150909002223 VA Practitioner - Radiation Oncology 3779725122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Saint Louis University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shenandoah Oncology PCGroup PAC ID 5698924843, 23 clinicians

Practice addresses (Care Compare)

400 Campus Blvd
Suite 100
Winchester, VA 22601-6906
Phone (540) 662-1108

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Oncology, PC Radiation Oncology CurrentSince Aug 1, 2015 Accepting new patients

Locations

400 Campus Blvd
Ste 100
Winchester, VA 22601
Phone (540) 662-1108

400 Campus Blvd
Ste 110
Winchester, VA 22601
Phone (540) 662-1108

Organizations & group practices 1

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": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1710130828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CAMPUS BLVD STE 100",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016906",
            "telephone_number": "540-662-1108",
            "fax_number": "450-540-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CAMPUS BLVD STE 110",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "22601",
            "telephone_number": "540-662-1108",
            "fax_number": "450-540-2244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Campus Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "22601",
            "country_code": "US",
            "telephone_number": "540-662-1108",
            "fax_number": "450-540-2244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOWALCHIK",
        "first_name": "KRISTIN",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-03",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "VA",
            "license": "0101258428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710130828",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.