Individual provider Active NPI

Kirstie Barbara Pistner, PA-C

  • Medical Physician Assistant
  • Dubois, PA
National Provider Identifier
1770049447
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA060557 Issued in PA
Practice address
635 Maple Avenue
Dubois, PA 15801
Phone
(814) 375-6379
NPI assigned
Feb 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA060557 PA
Medical Physician Assistant 363AM0700X OA004789 PA
Medical Physician Assistant 363AM0700X MA060557 PA Primary

Addresses

Primary practice location

635 Maple Avenue
Dubois, PA 15801

Mailing address

635 Maple Avenue
Dubois, PA 15801

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
I20190812001074 PA Practitioner - Physician Assistant 5092042200 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keystone Rural Health Consortia, Inc.Group PAC ID 8022055078, shared by 3 NPIs, 8 clinicians

Practice addresses (Care Compare)

90 E 2ND St
Emporium, PA 15834-1302
Phone (814) 486-1115

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.9 of 100Reported as group
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OA004789PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tyrone Hospital CurrentSince Feb 2, 2022 Accepting new patients
Elk Regional Health Center CurrentSince May 17, 2020 Accepting new patients
Dubois Regional Medical Group, PC Physician Assistant CurrentSince Dec 23, 2021 Accepting new patients
Elk Regional Health Center Physician Assistant CurrentSince May 17, 2020 Accepting new patients
Dubois Regional Medical Group, PC Physician Assistant CurrentSince Dec 23, 2021 Accepting new patients
Dubois Regional Medical Center Physician Assistant Past Accepting new patients
Pinecroft Medical Center Past Accepting new patients

Locations

145 Hospital Ave
Ste 102
Dubois, PA 15801
Phone (814) 375-6510

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

275 E 4th St
Emporium, PA 15834
Phone (814) 486-6123

120 Spring St
Houtzdale, PA 16651
Phone (814) 497-4297

111 Cobb St
Johnsonburg, PA 15845
Phone (814) 965-2857

763 Johnsonburg Rd
Saint Marys, PA 15857
Phone (814) 788-8000

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1770049447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 MAPLE AVENUE",
            "city": "DUBOIS",
            "state": "PA",
            "postal_code": "15801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 MAPLE AVENUE",
            "city": "DUBOIS",
            "state": "PA",
            "postal_code": "15801",
            "telephone_number": "814-375-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISTNER",
        "first_name": "KIRSTIE",
        "middle_name": "BARBARA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-18",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA060557",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA004789",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA060557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubois, PA

Sources for this page

Verify at the official NPI Registry.