Individual provider Active NPI

Karen Marie Kresevic, PA

  • Physician Assistant
  • Akron, OH
National Provider Identifier
1881656569
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50000890 Issued in OH
Practice address
29 N Adams St
Akron, OH 44304-1641
Phone
(330) 572-7300
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50000890 OH Primary

Addresses

Primary practice location

29 N Adams St
Akron, OH 44304-1641

Mailing address

10525 Bartholomew Rd
Chagrin Falls, OH 44023-2307

Other practice location 1

12300 McCracken Rd
Garfield Heights, OH 44125-2914
Phone (216) 581-0500

Other identifiers 2

IdentifierTypeStateIssuer
5601011774OtherMIMICHIGAN STATE LICENSE
085.009974OtherILILLINOIS STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
031013NYMDOccupational Therapist
50000890OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Urgent Care of Michigan, PC CurrentSince May 23, 2022 Accepting new patients
Hometown Urgent Care of Michigan, P.C. Current Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince May 23, 2022 Accepting new patients
Medina Emergency Associates LTD Past Accepting new patients

Locations

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

6210 Brandt Pike
Huber Heights, OH 45424
Phone (937) 236-8630

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1881656569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10525 BARTHOLOMEW RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440232307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 N ADAMS ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041641",
            "telephone_number": "330-572-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12300 McCracken Rd",
            "address_purpose": "LOCATION",
            "city": "Garfield Heights",
            "state": "OH",
            "postal_code": "441252914",
            "country_code": "US",
            "telephone_number": "216-581-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRESEVIC",
        "first_name": "KAREN",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50000890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN STATE LICENSE",
            "identifier": "5601011774",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS STATE LICENSE",
            "identifier": "085.009974",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.