Individual provider Active NPI

Kristen Emily Mestayer Peske, D.O.

  • Obstetrics & Gynecology Physician
  • MC Murray, PA
National Provider Identifier
1720307333
Registry record updated Jan 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
OS015165 Issued in PA
Practice address
3928 Washington Rd
MC Murray, PA 15317-2537
Phone
(724) 941-1866
Fax
(724) 941-1647
NPI assigned
May 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X OS015165 PA Primary

Addresses

Primary practice location

3928 Washington Rd
MC Murray, PA 15317-2537

Mailing address

3928 Washington Rd
MC Murray, PA 15317-2537
Phone (724) 941-1866

Other identifiers 1

IdentifierTypeStateIssuer
1025333790001MedicaidPA

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
I20120917000321 PA Practitioner - Obstetrics/Gynecology 5799933750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Philadelphia College of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Women'S Care of Pittsburgh, P.C.Group PAC ID 0547225245, 6 clinicians

Practice addresses (Care Compare)

3928 Washington Rd
Suite 230
MC Murray, PA 15317-2594
Phone (724) 941-1866

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS015165PAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients

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.

Hospital & facility affiliations 7

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": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388966400000",
    "number": "1720307333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3928 WASHINGTON RD",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153172537",
            "telephone_number": "724-941-1866",
            "fax_number": "724-941-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3928 WASHINGTON RD",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153172537",
            "telephone_number": "724-941-1866",
            "fax_number": "724-941-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESKE",
        "first_name": "KRISTEN",
        "middle_name": "EMILY MESTAYER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-21",
        "last_updated": "2014-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "OS015165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025333790001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Murray, PA

Sources for this page

Verify at the official NPI Registry.