Laura Susanne Kovacik, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

6005 Monclova Rd
Maumee, OH 43537-1864

Phone

(419) 893-2663

Fax

(419) 893-7240

NPI assigned

May 23, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Physician Assistant

Education

Toledo Medical College, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Promedica Central Physicians

  • Durable Medical Equipment & Medical Supplies
  • Toledo, OH
  • NPI 1669068482
  NPD
• The Toledo Hospital

  • Community/Retail Pharmacy
  • Toledo, OH
  • NPI 1740217678
  NPD (past)

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495497600000",
    "number": "1922536820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 MARILYN DR",
            "city": "ROSSFORD",
            "state": "OH",
            "postal_code": "434601512",
            "telephone_number": "419-304-0692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 MONCLOVA RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371864",
            "telephone_number": "419-893-2663",
            "fax_number": "419-893-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACIK",
        "first_name": "LAURA",
        "middle_name": "SUSANNE",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-23",
        "last_updated": "2017-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol R Kollarits, M.D.
• Michael L. Koltz, MD
• Melisa Ann Konesni
• Amy Konieczny, DPT
• Olivia Kosek
• Charlotte E Kramer, SLP
• Richard Krasula, PTA
• Frances Kraus, RBT
• Alleynah Marie Kreglow, RN
• Kimberly Krese

• Physician Assistant in Maumee, OH
• Providers in Maumee, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; 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.

Verify at the official NPI Registry.