Justin Tyler Kryak, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2751 Issued in SC

Practice address

701 Grove Rd FL 1
Greenville, SC 29605-4210

Phone

(864) 455-7899

Fax

(864) 455-5474

NPI assigned

Jun 14, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Prisma Health University Medical Group

  dba Department of Radiology

  • Diagnostic Radiology Physician
  • Greenville, SC
  • NPI 1568799955
  Medicare reassignment NPD
• Prisma Health University Medical Group

  dba Department of Radiology

  • Diagnostic Radiology Physician
  • Columbia, SC
  • NPI 1730786096
  Medicare reassignment NPD
• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment
• Prisma Health-Upstate

  dba Prisma Health Greenville Memorial Hospital

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1649726738
  Medicare reassignment
• Baptist Easley

  dba Baptist Easley Hospitalists

  • Hospitalist Physician
  • Easley, SC
  • NPI 1154859031

  Physician Assistant

  NPD
• Pathology Associates of Greenville PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Greenville, SC
  • NPI 1831151976
  NPD
• Prisma Health University Medical Group

  dba Parkside OB-GYN

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Prisma Health University Medical Group

  dba UMG Easley

  • Family Medicine Physician
  • Easley, SC
  • NPI 1295218642
  NPD
• Prisma Health-Upstate

  dba Prisma Health Cancer Inst-Grove

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1659827756
  NPD
• Prisma Health-Upstate

  dba Prisma Health Wonder Center-Non Medicaid

  • Medically Fragile Infants and Children Day Care
  • Greenville, SC
  • NPI 1811439649
  NPD

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1821528514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD FL 1",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-455-7899",
            "fax_number": "864-455-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRYAK",
        "first_name": "JUSTIN",
        "middle_name": "TYLER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2751",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "SCA624",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3003PA",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkryak170883@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jkryak170883@direct.ghs.myhfn.org",
            "address_1": "701 Grove Rd Fl 1",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296054210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mark B Krom, DO
• Lauren Shea Kropiwnicki
• Steven John Krozer, PMHNP-BC
• Kristina Krug-Wagner, CSTFA
• Brandon Robert Kryak, PA-C
• Joseph S Kubiak, Jr, MD
• John J Kudlak Jr., D.O.
• John Thomas Kuhl, MD
• James Lee Kuhlen Jr., M.D.
• Justin John Kuhlman, MD

• Physician Assistant in Greenville, SC
• Providers in Greenville, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.