Katelyn Hebeisen, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0006186 Issued in MD

Practice address

120 Sister Pierre Dr Ste 403
Towson, MD 21204-7536

Phone

(410) 823-6408

NPI assigned

Jul 20, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD, PA, DC3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psych Associates of Maryland LLCGroup PAC ID 3971550963, 151 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bloomhealthcenters.katelynhebeisen@131200.advancedmd-direct.com

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.

• Psych Associates of Maryland LLC

  • Psychologist
  • Timonium, MD
  • NPI 1891721981

  DC

  Medicare reassignment Care Compare group
• Delaware Valley Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1386864502
  Medicare reassignment NPD
• Delaware Valley Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1235956921
  NPD
• Neta, Inc.

  • Child & Adolescent Psychiatry Physician
  • Arlington, VA
  • NPI 1134506520
  NPD (past)

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1063865442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DR STE 403",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047536",
            "telephone_number": "410-823-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DR STE 403",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047536",
            "telephone_number": "410-823-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBEISEN",
        "first_name": "KATELYN",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059007",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0006186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BOARD OF HEALTH",
            "identifier": "C0006186",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hearts of Ireland Referral Agency of MD, LLC
• Kiera Heath
• Heather Marie Piercy
• Heather Z. Lyons, Licensed Psychologist, LLC
• Julia Heavner, PSYD
• Allison Morgan Hecht, PH.D.
• Tammie Hedgeman
• Kerry R Heemann, M.D.
• Chaya Hefter, M.S CCC SLP
• Laura Heid, LCSW-C

• Physician Assistant in Towson, MD
• Providers in Towson, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.