Individual provider Active NPI

Katherine Demeritt, P.A.

  • Medical Physician Assistant
  • Beaumont, TX
National Provider Identifier
1093852048
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10000552 Issued in IN
Practice address
3080 College St
Beaumont, TX 77701-4606
Phone
(409) 212-5000
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10000552 IN Primary

Addresses

Primary practice location

3080 College St
Beaumont, TX 77701-4606

Mailing address

109 Dolton Dr
Lumberton, TX 77657-8160
Phone (409) 227-4053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20121004000553 TX Practitioner - Physician Assistant 5395811129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Express of the Beaumont Area PAGroup PAC ID 5698816882, 211 clinicians

Practice addresses (Care Compare)

10850 Louetta Rd
Suite 1500
Houston, TX 77070-3537
Phone (281) 666-9981

8850 Spencer Hwy
La Porte, TX 77571-3736
Phone (281) 946-9980

9740 Barker Cypress Rd
Suite 108
Cypress, TX 77433-1974
Phone (281) 990-6890

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10000552INMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southlake Doctors Express, PA PSC Current Accepting new patients
Emergency Medicine of Indiana LLC Past Accepting new patients
Redimed Dekalb LLC Past Accepting new patients
St. Joseph Health System, LLC Past Accepting new patients
Emergency Medicine of Indiana Past Accepting new patients
Doctors Express of the Temple Area, PA Past Accepting new patients

Locations

2315 E Southlake Blvd
Ste 110
Southlake, TX 76092
Phone (817) 488-9922

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1093852048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 DOLTON DR",
            "city": "LUMBERTON",
            "state": "TX",
            "postal_code": "776578160",
            "telephone_number": "409-227-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 COLLEGE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014606",
            "telephone_number": "409-212-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMERITT",
        "first_name": "KATHERINE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10000552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.