NPIMap

Individual provider Active NPI

Joseph Randy Kalik, D.O.

  • Family Medicine Physician
  • Hermitage, PA
National Provider Identifier
1962498527
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS007078E Issued in PA
Practice address
295 N Kerrwood Dr
Suite #101
Hermitage, PA 16148-5207
Phone
(724) 347-5507
Fax
(724) 347-6320
NPI assigned
Sep 20, 2005
Reactivated
Mar 30, 2006
Last updated
Sep 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS007078E PA Primary

Addresses

Primary practice location

295 N Kerrwood Dr
Suite #101
Hermitage, PA 16148-5207

Mailing address

PO Box 1209
Hermitage, PA 16148-0209
Phone (724) 347-5507

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
I20120109000090 PA Practitioner - Family Practice 8527234863 Practice locations: Hermitage, PA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
College of Physicians and Surgeons (Iowa), 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novacare Rehabilitation of Ohio IncGroup PAC ID 0345159315, shared by 5 NPIs, 76 clinicians

Practice addresses (Care Compare)

295 N Kerrwood Dr
Suite 101
Hermitage, PA 16148-5207
Phone (724) 347-5507

656 Youngstown Warren Rd
Niles, OH 44446-4356
Phone (330) 505-1362

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy23
Removal of tissue1-10
Removal of skin lesions21
Removal of nail tissue11
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Embassy Hermitage, LLC Past Accepting new patients
Embassy Sharon, LLC Past Accepting new patients

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1962498527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1209",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161480209",
            "telephone_number": "724-347-5507",
            "fax_number": "724-347-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 N KERRWOOD DR",
            "address_2": "SUITE #101",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161485207",
            "telephone_number": "724-347-5507",
            "fax_number": "724-347-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALIK",
        "first_name": "JOSEPH",
        "middle_name": "RANDY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2011-09-19",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS007078E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, PA

Sources for this page

Verify at the official NPI Registry.