Individual provider Active NPI

Chad A Kaltenbach, CRNP

  • Family Nurse Practitioner
  • Erie, PA
National Provider Identifier
1720858178
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP029030 Issued in PA
Practice address
145 W 23Rd St Ste 101
Erie, PA 16502-2858
Phone
(814) 452-2767
Fax
(814) 459-2976
NPI assigned
Jan 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP029030 PA Primary

Addresses

Primary practice location

145 W 23Rd St Ste 101
Erie, PA 16502-2858

Mailing address

145 W 23Rd St Ste 101
Erie, PA 16502-2858
Phone (814) 452-2767

Other identifiers 2

IdentifierTypeStateIssuer
104309021MedicaidPA
16176838OtherCAQH

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
I20240417000016 PA Practitioner - Nurse Practitioner 8325487804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

145 W 23Rd St
101 Digestive Diseases of NW PA
Erie, PA 16502-2858
Phone (814) 452-2767

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP029030PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Medical Education and Research Institute Inc CurrentSince Mar 10, 2024 Accepting new patients

Locations

155 E State St
Albion, PA 16401
Phone (814) 756-4917

145 W 23rd St
Ste 101
Erie, PA 16502
Phone (814) 452-2767

Interoperability endpoints

  • Direct secure messaging: ckaltenbach149829@direct.ahn.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1720858178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 W 23RD ST STE 101",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022858",
            "telephone_number": "814-452-2767",
            "fax_number": "814-459-2976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 W 23RD ST STE 101",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022858",
            "telephone_number": "814-452-2767",
            "fax_number": "814-459-2976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALTENBACH",
        "first_name": "CHAD",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP029030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104309021",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "16176838",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.