Individual provider Active NPI

Kaitlin Kozak

  • Registered Nurse
  • Erie, PA
National Provider Identifier
1730943655
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN696521 Issued in PA
Practice address
201 State St
Erie, PA 16550-0001
Phone
(814) 877-2938
NPI assigned
Feb 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN696521 PA Primary

Addresses

Primary practice location

201 State St
Erie, PA 16550-0001

Mailing address

4408 Hammocks Dr Apt 106
Erie, PA 16506-7426

Other identifiers 1

IdentifierTypeStateIssuer
RN696521OtherPAPA RN LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL kozak007@upmc.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250819001392 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385143189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 293-4500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN696521PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Aug 4, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Aug 4, 2025 Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

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 1

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": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1730943655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4408 HAMMOCKS DR APT 106",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165067426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165500001",
            "telephone_number": "814-877-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "KAITLIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN696521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA RN LICENSE",
            "identifier": "RN696521",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kozak007@upmc.edu",
            "affiliation": "N",
            "endpointDescription": "Hospital E-mail address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Hospital E-mail address",
            "address_1": "201 State St",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165500001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.