Anna Magdalena Kielak

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP60657873 Issued in WA

Practice address

20174 Front St NE
Poulsbo, WA 98370-7445

Phone

(360) 697-1141

NPI assigned

Jun 3, 2016

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 WA

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

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Front Street Clinic IncGroup PAC ID 5193612935, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Front Street Clinic Inc

  • Psychologist
  • Poulsbo, WA
  • NPI 1457532913
  Medicare reassignment Care Compare group NPD
• Wandee J. Pryor, Psy.D., LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Poulsbo, WA
  • NPI 1376043232
  NPD (past)

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1952750671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1611",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983700197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20174 FRONT ST NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707445",
            "telephone_number": "360-697-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELAK",
        "first_name": "ANNA",
        "middle_name": "MAGDALENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60657873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Michael Kelln, PHD, MPT
• Diane Claire Kelly, LMHC,
• Ashley Marie Kennedy, MSW
• Kristin L Kennedy, LMHC
• Nathan P Kerestes, DO
• Shioon Kim, D.M.D
• George Kina, M.D.
• Erica Lynn Kinerk, RDH
• Jorgie Katherine Kinerk, RDH
• Eve King-Hill, MA, LMHC

• Psychiatric/Mental Health Nurse Practitioner in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; 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.