NPIMap

Organization Active NPI

Richard M Kastelic MD & Assoc PC

  • Family Medicine Physician
  • Johnstown, PA
National Provider Identifier
1821042417
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD040121L Issued in PA
Legal business name
RICHARD M KASTELIC MD & ASSOC PC
Practice address
322 Warren St
Ste 300
Johnstown, PA 15905-3437
Phone
(814) 288-4498
Fax
(814) 288-5427
NPI assigned
May 19, 2006
Last updated
Nov 13, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Authorized official

Name
Richard M. Kastelic, MDNPI 1548265986
Title
President
Phone
(814) 288-1418

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MD040121L PA Primary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X MD040121L PA

Addresses

Primary practice location

322 Warren St
Ste 300
Johnstown, PA 15905-3437

Mailing address

322 Warren St
Ste 300
Johnstown, PA 15905-3443
Phone (814) 288-4498

Other identifiers 2

IdentifierTypeStateIssuer
1007743550005MedicaidPA
1007743550007MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040628001565 PA Part B Supplier - Clinic/Group Practice 8022094150 Receives reassigned benefits from 9 practitioners
Practice locations: Johnstown, PA

National Provider Directory

National Provider Directory

Locations

311 Warren St
Ste 100
Johnstown, PA 15905
Phone (814) 288-4498

322 Warren St
Johnstown, PA 15905
Phone (814) 255-4688

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1821042417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 WARREN ST",
            "address_2": "STE 300",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159053443",
            "telephone_number": "814-288-4498",
            "fax_number": "814-288-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 WARREN ST",
            "address_2": "STE 300",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159053437",
            "telephone_number": "814-288-4498",
            "fax_number": "814-288-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD M KASTELIC MD & ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "KASTELIC",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-288-1418",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD040121L",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "MD040121L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007743550005",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007743550007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.