Individual provider Active NPI

Kayla Rose Lusnia, PA-C

  • Medical Physician Assistant
  • South Hadley, MA
National Provider Identifier
1831748243
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA7097 Issued in MA
Practice address
470 Granby Rd Ste 1
South Hadley, MA 01075-3215
Phone
(413) 794-8700
Fax
(413) 794-8732
NPI assigned
Sep 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA7097 MA
Medical Physician Assistant 363AM0700X PA7097 MA Primary

Addresses

Primary practice location

470 Granby Rd Ste 1
South Hadley, MA 01075-3215

Mailing address

280 Chestnut St FL 2
Springfield, MA 01199-1001
Phone (413) 794-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200201000125 MA Practitioner - Physician Assistant 8820424369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

280 Chestnut St
Suite 2
Springfield, MA 01199-1001

3400 Main St
Springfield, MA 01107-1113
Phone (413) 794-8777

470 Granby Rd
South Hadley, MA 01075-3218
Phone (413) 794-2273

759 Chestnut St
Springfield, MA 01199-1001
Phone (413) 794-5439

Hospital & facility affiliations

  • Baystate Medical Center Hospital, Springfield, MA, CCN 220077
  • Baystate Wing Hospital Hospital, Palmer, MA, CCN 220030
  • Baystate Noble Hospital Hospital, Westfield, MA, CCN 220065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA7097MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc CurrentSince Dec 4, 2019 Accepting new patients

Locations

230 Main St
Agawam, MA 01001
Phone (413) 733-6700

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

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 4

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": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1831748243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST FL 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 GRANBY RD STE 1",
            "city": "SOUTH HADLEY",
            "state": "MA",
            "postal_code": "010753215",
            "telephone_number": "413-794-8700",
            "fax_number": "413-794-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSNIA",
        "first_name": "KAYLA",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7097",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA7097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Hadley, MA

Sources for this page

Verify at the official NPI Registry.