NPIMap

Individual provider Active NPI

Kathleen A McDaniel, PA-C

  • Physician Assistant
  • Gig Harbor, WA
National Provider Identifier
1033128459
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10003808 Issued in WA
Practice address
11511 Canterwood Blvd Ste 205
Gig Harbor, WA 98332-5818
Phone
(253) 530-2663
NPI assigned
Aug 5, 2006
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10003808 WA Primary

Addresses

Primary practice location

11511 Canterwood Blvd Ste 205
Gig Harbor, WA 98332-5818

Mailing address

11511 Canterwood Blvd Ste 205
Gig Harbor, WA 98332-5818
Phone (253) 530-2663

Other identifiers 3

IdentifierTypeStateIssuer
0201042OtherWASTATE L&I
0201048OtherWASTATE L&I
1042578MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmcdaniel21908@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20040727000185 WA Practitioner - Physician Assistant 5496725772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1608 S J St
FL 4
Tacoma, WA 98405-4930
Phone (253) 274-7504

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10003808WAMDPhysician Assistant
PA10003803WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Nov 6, 2015 Accepting new patients
Franciscan Medical Group CurrentSince Nov 6, 2015 Accepting new patients
Advanced Orthopaedic Associates, P.a. PastSince Jul 23, 2023 Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

11511 Canterwood Blvd
Ste 205
Gig Harbor, WA 98332
Phone (253) 530-2663

4700 Point Fosdick Dr
Gig Harbor, WA 98335
Phone (253) 851-6075

4700 Point Fosdick Dr
Ste 111
Gig Harbor, WA 98335
Phone (253) 851-6075

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 6

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1033128459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD STE 205",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325818",
            "telephone_number": "253-530-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD STE 205",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325818",
            "telephone_number": "253-530-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0201042",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0201048",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1042578",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmcdaniel21908@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11511 Canterwood Blvd Ste 205",
            "city": "Gig Harbor",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983325818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

Verify at the official NPI Registry.