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Individual provider Active NPI

Michelle M Kilbane, PA-C

  • Surgical Physician Assistant
  • Akron, OH
National Provider Identifier
1982030326
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.003933RX Issued in OH
Practice address
3975 Embassy Pkwy
Akron, OH 44333-8320
Phone
(330) 668-4040
Fax
(330) 668-4078
NPI assigned
Sep 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50.003933RX OH Primary

Addresses

Primary practice location

3975 Embassy Pkwy
Akron, OH 44333-8320

Mailing address

3975 Embassy Pkwy
Akron, OH 44333-8320

Other identifiers 1

IdentifierTypeStateIssuer
0096821MedicaidOH

Other names 1

  • Michelle M Czyzyk Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20140206000816 OH Practitioner - Physician Assistant 3072742410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crystal Clinic, Inc.Group PAC ID 7214821586, 46 clinicians

Practice addresses (Care Compare)

3975 Embassy Pkwy
Suite 202
Akron, OH 44333-8395
Phone (330) 668-4085

437 Portage Trail
Cuyahoga Falls, OH 44221-3227
Phone (330) 929-9136

437 Portage TRL
Cuyahoga Falls, OH 44221-3227
Phone (330) 929-9136

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as group
Quality
83.94
Promoting interoperability
100
Improvement activities
40
Cost
78.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.003933RXOHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Clinic Inc CurrentSince Aug 15, 2017 Accepting new patients
Crystal Clinic Orthopaedic Center, LLC Past Accepting new patients

Locations

3975 Embassy Pkwy
Akron, OH 44333
Phone (330) 670-4242

4466 Fulton Dr NW
Canton, OH 44718
Phone (330) 489-1386

437 Portage Trl
Cuyahoga Fls, OH 44221
Phone (330) 929-9136

3975 Embassy Pkwy
Ste 102
Fairlawn, OH 44333
Phone (330) 668-4050

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 and National Provider Directory roles.

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": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1982030326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 EMBASSY PKWY",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443338320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 EMBASSY PKWY",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443338320",
            "telephone_number": "330-668-4040",
            "fax_number": "330-668-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILBANE",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.003933RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096821",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "CZYZYK",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.