Active NPI
Kristen A Buerstatte, PA-C
- Physician Assistant
- Quincy, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085009530
- Practice address
- 927 Broadway St
Quincy, IL 62301-2719 - Phone
- (217) 214-3424
- Fax
- (217) 221-1344
- NPI assigned
- Dec 10, 2012
- Last updated
- Apr 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085009530 | IL | Primary |
| Physician Assistant | 363A00000X | 2023040348 | MO |
Addresses
Primary practice location
927 Broadway St
Quincy, IL 62301-2719
Mailing address
1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400
Other practice location 1
100 Medical Dr
Hannibal, MO 63401-6877
Phone (217) 224-6423
Other names 1
- Kristen A Vahle
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Medical Dr
Hannibal, MO 63401-6877
Phone (573) 406-5800
1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400
101 Medical Dr
Hannibal, MO 63401-6884
Phone (573) 221-5250
927 Broadway St
Quincy, IL 62301-2719
Phone (217) 224-6423
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023040348 | MO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blessing Hospital | Current | Accepting new patients | |
| West Central Pathology Specialists, S.C. | Current | Accepting new patients | |
| Blessing Hospital | Current | Accepting new patients | |
| Quincy Clinical Laboratory Services SC | Current | Accepting new patients | |
| Blessing Hospital | Current | Accepting new patients | |
| Medgen Urgent Care Maryland LLC | Past | Accepting new patients | |
| Blessing Hospital | Past | Accepting new patients | |
| Physical Medicine Associates LTD | Past | Accepting new patients |
Locations
1005 Broadway St
Quincy, IL 62301
100 Medical Dr
Hannibal, MO 63401
101 Medical Dr
Hannibal, MO 63401
Interoperability endpoints
- https://fhir.blessinghospital.com/R4/open-Prod
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Nurse Practitioner
- Quincy, IL
- NPI 1417204827
-
- Anatomic Pathology & Clinical Pathology Physician
- Quincy, IL
- NPI 1114773272
-
- Anatomic Pathology & Clinical Pathology Physician
- Quincy, IL
- NPI 1083895452
-
dba Blessing Health Monroe City
- Rural Health Clinic/Center
- Monroe City, MO
- NPI 1013683507
-
dba Blessing ER Physician Group
- Emergency Medical Services (Emergency Medicine) Physician
- Quincy, IL
- NPI 1558489021
-
- Urgent Care Clinic/Center
- Bethesda, MD
- NPI 1063803005
-
- Clinical Laboratory Director (Non-physician)
- Columbia, MD
- NPI 1750840666
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Quincy, IL
- NPI 1760571699
-
dba Scotland County Hospital
- Critical Access Hospital
- Memphis, MO
- NPI 1083624647
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712275200000",
"number": "1841535309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 BROADWAY ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623012834",
"telephone_number": "217-223-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "927 BROADWAY ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623012719",
"telephone_number": "217-214-3424",
"fax_number": "217-221-1344"
}
],
"practiceLocations": [
{
"address_1": "100 Medical Dr",
"address_purpose": "LOCATION",
"city": "Hannibal",
"state": "MO",
"postal_code": "634016877",
"country_code": "US",
"telephone_number": "217-224-6423",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUERSTATTE",
"first_name": "KRISTEN",
"middle_name": "A",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-10",
"last_updated": "2024-04-05",
"certification_date": "2024-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085009530",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2023040348",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTEN",
"last_name": "VAHLE",
"middle_name": "A",
"credential": "PA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Quincy, IL
- Kolton Chase Bruce, HIS
- Bruening Total Wellness Center LLC
- Brandon Bruening, D.C.
- Garrett Brugman, ATC
- Karen Lori Buckwalter, L.C.S.W.
- Buffalo Prairie Dental Care of Quincy, Inc
- Buffalo Prairie Dental of Quincy, PLLC
- Buffalo Prairie Dental Surgery and Sedation Center PLLC
- Benjamin Bukey
- Kristie Kathryn Bunch, OTR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.