Individual provider Active NPI

Krystian Szczesik, PA

  • Physician Assistant
  • Redlands, CA
National Provider Identifier
1891200887
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA55203 Issued in CA
Practice address
1901 W Lugonia Ave Ste 120
Redlands, CA 92374-9704
Phone
(909) 557-1600
NPI assigned
Dec 12, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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 PA55203 CA Primary

Addresses

Primary practice location

1901 W Lugonia Ave Ste 120
Redlands, CA 92374-9704

Mailing address

1801 Orange Tree LN Ste 200
Redlands, CA 92374-4587
Phone (909) 557-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180208002488 CA Practitioner - Physician Assistant 1557621786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Bernardino Medical Orthopaedic Group IncGroup PAC ID 9335045228, 92 clinicians

Practice addresses (Care Compare)

1901 W Lugonia Ave
Redlands, CA 92374-9703
Phone (909) 557-1600

2131 Elks Dr
201 Arrowhead Orthopaedics
San Bernardino, CA 92404-5572
Phone (909) 726-6100

Hospital & facility affiliations

  • Redlands Community Hospital Hospital, Redlands, CA, CCN 050272

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA55203CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
San Bernardino Medical Orthopaedic Group, Inc. CurrentSince Dec 17, 2017 Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. CurrentSince Dec 17, 2017 Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
San Bernardino Medical Group Inc Past Accepting new patients
Redlands Community Hospital Past Accepting new patients
Temecula Valley Hospital Inc Past Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

3889 W Stetson Ave
Ste 100
Hemet, CA 92545
Phone (951) 652-1600

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

1901 W Lugonia Ave
Ste 120
Redlands, CA 92374
Phone (909) 557-1626

1901 W Lugonia Ave
Ste 310
Redlands, CA 92374
Phone (909) 793-2964

1901 W Lugonia Ave
Ste 210
Redlands, CA 92374
Phone (909) 557-1653

1801 Orange Tree Ln
Ste 240
Redlands, CA 92374

1901 W Lugonia Ave
Ste 240
Redlands, CA 92374
Phone (909) 557-1630

1801 Orange Tree Ln
Ste 200
Redlands, CA 92374
Phone (909) 557-1607

2131 Elks Dr
Ste 200
San Bernardino, CA 92404
Phone (909) 726-6100

15095 Amargosa Rd
Ste 106
Victorville, CA 92394
Phone (760) 245-6495

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1891200887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 ORANGE TREE LN STE 200",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744587",
            "telephone_number": "909-557-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W LUGONIA AVE STE 120",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923749704",
            "telephone_number": "909-557-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZCZESIK",
        "first_name": "KRYSTIAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-12",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.