NPIMap

Individual provider Active NPI

Kaitlyn Elizabeth McDermitt, PA-C

  • Physician Assistant
  • Mason City, IA
National Provider Identifier
1033791900
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
117590 Issued in IA
Practice address
250 S Crescent Dr
Mason City, IA 50401-2926
Phone
(641) 494-5400
NPI assigned
Apr 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.006595RX OH
Physician Assistant 363A00000X 117590 IA Primary

Addresses

Primary practice location

250 S Crescent Dr
Mason City, IA 50401-2926

Mailing address

250 S Crescent Dr
Mason City, IA 50401-2926
Phone (641) 494-5400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address orthopedicsnurse@mcclinic.direct-ci.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20230126001339 IA Practitioner - Physician Assistant 5991114837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spencer Municipal HospitalGroup PAC ID 4183533060, 95 clinicians

Practice addresses (Care Compare)

1200 1St Ave E
Spencer, IA 51301-4330

1200 1St Ave E
Spencer, IA 51301-4342
Phone (712) 264-6198

1200 1St Ave E C
Nwia Bone Joint and Sports Surgeons
Spencer, IA 51301-4342
Phone (712) 262-7511

Hospital & facility affiliations

  • Spencer Municipal Hospital Hospital, Spencer, IA, CCN 160112
  • Kossuth Regional Health Center Hospital, Algona, IA, CCN 161353
  • Lakes Regional Healthcare Hospital, Spirit Lake, IA, CCN 160124
  • Palo Alto County Hospital Hospital, Emmetsburg, IA, CCN 161357

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.006595RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakes Regional Healthcare CurrentSince Apr 15, 2024 Accepting new patients
Spencer Municipal Hospital CurrentSince Apr 15, 2024 Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Spencer Municipal Hospital CurrentSince Apr 15, 2024 Accepting new patients
Spencer Municipal Hospital Past Accepting new patients

Locations

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

1200 1st Ave E
Ste C
Spencer, IA 51301
Phone (712) 262-7511

Organizations & group practices 7

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 7

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": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1033791900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S CRESCENT DR",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012926",
            "telephone_number": "641-494-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S CRESCENT DR",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012926",
            "telephone_number": "641-494-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMITT",
        "first_name": "KAITLYN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006595RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "117590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "orthopedicsnurse@mcclinic.direct-ci.net",
            "affiliation": "N",
            "endpointDescription": "Mason City Clinic direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "250 S Crescent Dr",
            "city": "Mason City",
            "state": "IA",
            "country_code": "US",
            "postal_code": "504012926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

Verify at the official NPI Registry.