Individual provider Active NPI

Paul Kolecki, M.D.

  • Emergency Medicine Physician
  • Springfield, PA
National Provider Identifier
1710902226
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD-066470-L Issued in PA
Practice address
417 Baltimore Pike
Springfield, PA 19064-3810
Phone
(484) 470-2600
Fax
(215) 952-9138
NPI assigned
Jul 13, 2006
Last updated
Aug 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD-066470-L PA Primary

Addresses

Primary practice location

417 Baltimore Pike
Springfield, PA 19064-3810

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 822-4355

Other identifiers 2

IdentifierTypeStateIssuer
7755708MedicaidNJ
001716012MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PAExchange@patientfirstclinics.com Health Information Exchange (HIE)

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041122001117 PA Practitioner - Emergency Medicine 2264497981 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

417 Baltimore Pike
Springfield, PA 19064-3810
Phone (484) 470-2600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-066470-LPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Pennsylvania Medical Group PLLC CurrentSince Jul 9, 2021 Accepting new patients
Patient First Pennsylvania Medical Group PLLC CurrentSince Jul 9, 2021 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Apr 23, 2019 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Apr 23, 2019 Accepting new patients

Locations

5125 Jonestown Rd
Ste 105
Harrisburg, PA 17112
Phone (717) 943-1566

713 Bethlehem Pike
Montgomeryvle, PA 18936
Phone (267) 695-3944

700 Walnut St
Philadelphia, PA 19106
Phone (215) 503-7300

417 Baltimore Pike
Springfield, PA 19064
Phone (484) 470-2600

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

Interoperability endpoints

  • Direct secure messaging: paexchange@patientfirstclinics.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1710902226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-822-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 BALTIMORE PIKE",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643810",
            "telephone_number": "484-470-2600",
            "fax_number": "215-952-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLECKI",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD-066470-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7755708",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001716012",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "417 Baltimore Pike",
            "city": "Springfield",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190643810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, PA

Sources for this page

Verify at the official NPI Registry.