Individual provider Active NPI

Kari Ann Pietralczyk, AUD, CCC-A

  • Audiologist
  • Forty Fort, PA
National Provider Identifier
1932361102
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT006075 Issued in PA
Practice address
190 Welles Street
Forty-Fort, PA 18704
Phone
(570) 283-0524
Fax
(570) 283-0302
NPI assigned
Jun 30, 2008
Last updated
Dec 21, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT006075 PA Primary

Addresses

Primary practice location

190 Welles Street
Forty-Fort, PA 18704

Mailing address

190 Welles Street
Forty-Fort, PA 18704
Phone (570) 283-0524

Other identifiers 1

IdentifierTypeStateIssuer
102207434MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080904000084 PA Practitioner - Qualified Audiologist 7517033236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley ENT, P.C.Group PAC ID 0042374613, 6 clinicians

Practice addresses (Care Compare)

190 Welles St
Forty Fort, PA 18704-4968
Phone (570) 283-0524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Valley ENT, P.C. CurrentSince Oct 15, 2010 Accepting new patients
Hearusa Inc Past Accepting new patients

Locations

190 Welles St
Kingston, PA 18704
Phone (570) 283-0524

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1932361102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 WELLES STREET",
            "city": "FORTY-FORT",
            "state": "PA",
            "postal_code": "18704",
            "telephone_number": "570-283-0524",
            "fax_number": "570-283-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 WELLES STREET",
            "city": "FORTY-FORT",
            "state": "PA",
            "postal_code": "18704",
            "telephone_number": "570-283-0524",
            "fax_number": "570-283-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRALCZYK",
        "first_name": "KARI",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "AUD, CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT006075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102207434",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forty Fort, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.