| Kacper Kisala, PA-C | |
|
148 Hazard Ave, Enfield, CT 06082-4520 | |
| (860) 763-7650 | |
| Not Available |
| Full Name | Kacper Kisala |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 4 Years |
| Location | 148 Hazard Ave, Enfield, Connecticut |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518704030 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | 6665 (Connecticut) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy Medical Ctr | Springfield, MA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Trinity Health Of New England Provider Network Organization Inc | 0941113567 | 644 |
| Riverbend Medical Group Inc | 5698064343 | 227 |
| Entity Name | Trinity Health of New England Provider Network Organization Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003882812 PECOS PAC ID: 0941113567 Enrollment ID: O20031110000651 |
| Mailing Address | Practice Location Address |
|---|---|
| Kacper Kisala, PA-C 14 Sam West Rd, Southwick, MA 01077-9734 Ph: (413) 250-1604 | Kacper Kisala, PA-C 148 Hazard Ave, Enfield, CT 06082-4520 Ph: (860) 763-7650 |
Mrs. Melissa D'amato, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 140 Hazard Ave Ste 105, Enfield, CT 06082 Phone: 860-714-9733 Fax: 860-714-8136 |
Madeline Murphy, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 170 Hazard Ave, Enfield, CT 06082 Phone: 860-749-2022 Fax: 860-763-1398 |
Brianna Mae Jarvis, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 55 Hazard Ave, Enfield, CT 06082 Phone: 860-745-9911 |
Brian P Weber, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 55 Hazard Ave, Enfield, CT 06082 Phone: 860-745-9911 |
Marissa Cardell, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 155 Hazard Ave Ste 2, Enfield, CT 06082 Phone: 860-698-6041 |
Mrs. Sarah Leigh Lasala, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 113 Elm St Ste 304, Enfield, CT 06082 Phone: 860-741-2225 Fax: 860-741-2229 |
Julie M Wondolowski, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 701 Enfield St, Enfield, CT 06082 Phone: 860-741-6058 Fax: 860-741-6864 |