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Kiersten Dykstra

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

300 Halket St Ste 4500, Pittsburgh, PA 15213

PECOS Enrollment

Based on the most recent information from CMS, provider Kiersten Dykstra is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1396162640
Provider Type
Individual
Full Name
Dykstra, Kiersten
Credential
OTR/L, PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
3/25/2014
Last Updated
6/26/2018

Contact Information

Practice Location

300 Halket St Ste 4500, Pittsburgh, PA 15213

(412) 641-6600

Unlisted Fax

Mailing Location

201 Franklin Ave, Apt 1, Pittsburgh, PA 15221-2739

(724) 396-8586

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License OA003886 Pennsylvania
Code 225XP0200X	Description Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License OC013274 Pennsylvania
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Kiersten Dykstra

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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