Individual provider Active NPI

Mario Kinsella

  • Pulmonary Disease Physician
  • Erie, PA
National Provider Identifier
1790787547
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD-046952-L Issued in PA
Practice address
2500 W 12TH St Ste C
Suite C
Erie, PA 16505-4500
Phone
(814) 877-8730
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD-046952-L PA Primary

Addresses

Primary practice location

2500 W 12TH St Ste C
Suite C
Erie, PA 16505-4500

Mailing address

2500 W 12TH St Ste C
Suite C
Erie, PA 16505-4500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mario.kinsella@upmcdirect.com UPMC

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
I20040309000437 PA Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 8224926472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regional Health Services IncGroup PAC ID 4880593722, 572 clinicians

Practice addresses (Care Compare)

201 State St
Erie, PA 16550-0002
Phone (814) 877-6000

2500 W 12TH St
Erie, PA 16505-4500
Phone (814) 838-0491

3406 Peach St
Erie, PA 16508-2740
Phone (814) 877-5381

Hospital & facility affiliations

  • Upmc Hamot Hospital, Erie, PA, CCN 390063

Merit-based Incentive Payment System (MIPS)

Final score
81.89 of 100Reported as group
Quality
65.8
Promoting interoperability
100
Improvement activities
40
Cost
73.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-046952-LPAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Services Inc CurrentSince Mar 1, 2015 Accepting new patients
West Penn Allegheny Health System, Inc. Pulmonary Disease Past Accepting new patients
Butler Medical Providers Past Accepting new patients

Locations

3406 Peach St
Erie, PA 16508
Phone (814) 877-5381

2500 W 12th St
Ste C
Erie, PA 16505
Phone (814) 877-8730

1781 W 26th St
Erie, PA 16508
Phone (814) 454-5896

201 State St
Erie, PA 16550
Phone (814) 877-2137

2 Hot Metal St
Ste 1
Pittsburgh, PA 15203

Interoperability endpoints

  • Direct secure messaging: mkinsella138864@upmc.direct-ci.com

Organizations & group practices 3

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 2

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1790787547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W 12TH ST STE C",
            "address_2": "SUITE C",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165054500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W 12TH ST STE C",
            "address_2": "SUITE C",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165054500",
            "telephone_number": "814-877-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSELLA",
        "first_name": "MARIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2021-04-06",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD-046952-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mario.kinsella@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.