NPIMap

Individual provider Active NPI

Kevin Paisley, M.D.

  • Diagnostic Radiology Physician
  • Brookville, PA
National Provider Identifier
1952381386
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD066686L Issued in PA
Practice address
100 Hospital Rd
Brookville, PA 15825-1367
Phone
(814) 849-1471
NPI assigned
Jan 20, 2006
Last updated
Nov 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD066686L PA Primary

Addresses

Primary practice location

100 Hospital Rd
Brookville, PA 15825-1367

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-4200

Other practice location 1

100 Hospital Rd
Brookville, PA 15825-1367
Phone (814) 849-2312

Other practice location 2

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-3261

Other identifiers 2

IdentifierTypeStateIssuer
001815440MedicaidPA
747030OtherPAPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060323000364 PA Practitioner - Diagnostic Radiology 6709894314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Pittsburgh School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dubois Regional Medical CenterGroup PAC ID 5890689715, 424 clinicians
Indiana Regional Imaging, PCGroup PAC ID 4082742812, 6 clinicians

Practice addresses (Care Compare)

100 Hospital Rd
Brookville, PA 15825-1367
Phone (814) 849-1892

835 Hospital Rd
Indiana, PA 15701-3629
Phone (800) 223-5544

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD066686LPAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center Diagnostic Radiology CurrentSince Nov 5, 2018 Accepting new patients
Dubois Regional Medical Center CurrentSince Nov 5, 2018 Accepting new patients

Locations

100 Hospital Rd
Brookville, PA 15825
Phone (814) 849-1408

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

Organizations & group practices 3

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.

Hospital & facility affiliations 49

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1952381386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-4200",
            "fax_number": "814-375-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158251367",
            "telephone_number": "814-849-1471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Brookville",
            "state": "PA",
            "postal_code": "158251367",
            "country_code": "US",
            "telephone_number": "814-849-2312",
            "fax_number": "814-849-4841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Hospital Ave",
            "address_purpose": "LOCATION",
            "city": "Du Bois",
            "state": "PA",
            "postal_code": "158011440",
            "country_code": "US",
            "telephone_number": "814-375-3261",
            "fax_number": "814-375-3397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAISLEY",
        "first_name": "KEVIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD066686L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001815440",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "747030",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookville, PA

Sources for this page

Verify at the official NPI Registry.