Individual provider Active NPI

Andrea Krasnowiecki, PA-C

  • Physician Assistant
  • East Greenwich, RI
National Provider Identifier
1922476258
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01082 Issued in RI
Practice address
1598 S County TRL Ste 115
East Greenwich, RI 02818-1762
Phone
(401) 884-0333
NPI assigned
Sep 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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 PA01082 RI Primary

Addresses

Primary practice location

1598 S County TRL Ste 115
East Greenwich, RI 02818-1762

Mailing address

10 Davol SQ Ste 400
Providence, RI 02903-4760
Phone (401) 421-4000

Other identifiers 1

IdentifierTypeStateIssuer
1922476258MedicaidRI

Other names 1

  • Andrea Bakalakis Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address akrasnowiecki221065@direct.lifespan.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20190228001356 RI Practitioner - Physician Assistant 2567701006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians

Practice addresses (Care Compare)

1598 S County TRL
Suite 201
East Greenwich, RI 02818-1762
Phone (401) 884-0333

900 Warren Ave
East Providence, RI 02914-1430

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • South County Hospital Inc Hospital, Wakefield, RI, CCN 410008
  • Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01082RIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Corporation Current Accepting new patients
Coastal Medical Physicians, Inc. CurrentSince Apr 25, 2021 Accepting new patients
Coastal Medical, Inc. Past Accepting new patients

Locations

1598 S County Trl
Ste 201
East Greenwich, RI 02818
Phone (401) 884-0333

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

Interoperability endpoints

  • Direct secure messaging: akrasnowiecki221065@brownhealth.medalliesdirect.net

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.

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": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1922476258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DAVOL SQ STE 400",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034760",
            "telephone_number": "401-421-4000",
            "fax_number": "401-272-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1598 S COUNTY TRL STE 115",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028181762",
            "telephone_number": "401-884-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASNOWIECKI",
        "first_name": "ANDREA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922476258",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akrasnowiecki221065@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "1598 S County Trl Ste 115",
            "city": "East Greenwich",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028181762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "BAKALAKIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in East Greenwich, RI

Sources for this page

Verify at the official NPI Registry.