NPIMap

Individual provider Active NPI

Charlene Kreiensieck, P.A

  • Physician Assistant
  • Laconia, NH
National Provider Identifier
1710990841
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0377 Issued in NH
Practice address
724 N Main St
Laconia, NH 03246-2742
Phone
(603) 524-5151
NPI assigned
Aug 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0377 NH Primary

Addresses

Primary practice location

724 N Main St
Laconia, NH 03246-2742

Mailing address

724 N Main St
Laconia, NH 03246-2742
Phone (603) 524-5151

Other identifiers 1

IdentifierTypeStateIssuer
30331636MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20050321000122 NH Practitioner - Physician Assistant 7517912801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Concord Hospital-LaconiaGroup PAC ID 7012326259, 275 clinicians

Practice addresses (Care Compare)

238 Daniel Webster Hwy
Meredith, NH 03253-5803
Phone (603) 279-7464

724 N Main St
Laconia, NH 03246-2742
Phone (603) 524-5151

80 Highland St
Laconia, NH 03246-3235
Phone (603) 527-4500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89 of 100Reported as apm
Quality
73.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
377NHMDMental Health Counselor
0377NHMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Hospital-Laconia CurrentSince May 1, 2021 Accepting new patients
Concord Hospital-Franklin CurrentSince Oct 1, 2013 Accepting new patients
Lrghealthcare CurrentSince Oct 1, 2013 Accepting new patients
Concord Hospital-Laconia Past Accepting new patients
LRG Healthcare Past Accepting new patients

Locations

250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711

724 N Main St
Laconia, NH 03246
Phone (603) 524-5151

80 Highland St
Laconia, NH 03246
Phone (603) 527-7100

238 Daniel Webster Hwy
Meredith, NH 03253
Phone (603) 279-7464

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 11

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710990841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 N MAIN ST",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "032462742",
            "telephone_number": "603-524-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 N MAIN ST",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "032462742",
            "telephone_number": "603-524-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREIENSIECK",
        "first_name": "CHARLENE",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30331636",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laconia, NH

Sources for this page

Verify at the official NPI Registry.