Keystone Pain and Rehabilitation, LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

OS-007929L Issued in PA

Legal business name

KEYSTONE PAIN AND REHABILITATION, LLC

Practice address

1 Lemoyne SQ
Suite 100
Lemoyne, PA 17043-1230

Phone

(717) 718-9459

Fax

(717) 718-9760

NPI assigned

Nov 2, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Asit P Upadhyay, D.O.

Title

President

Phone

(717) 718-9459

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1952853376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 6TH AVE",
            "address_2": "SUITE 110",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174032626",
            "telephone_number": "717-718-9459",
            "fax_number": "717-718-9760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LEMOYNE SQ",
            "address_2": "SUITE 100",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431230",
            "telephone_number": "717-718-9459",
            "fax_number": "717-718-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE PAIN AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "UPADHYAY",
        "authorized_official_first_name": "ASIT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-718-9459",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "PA",
            "license": "OS-007929L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001396610 0003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "444680",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sonya C Johnson, RPH
• Gary W Karkuff, P.T.
• Kay LLC
• Ashley Ann Kelly
• Roger Bruce Kelly, MA
• Dale King
• Megan Kirsch
• Alyssa Marie Klinedinst, PTA
• Elena Kozochonok, M.D
• Gabrielle Marie Kulig, CRNP

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Lemoyne, PA
• Providers in Lemoyne, PA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.