Katelyn Black

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA057785 Issued in PA

Practice address

10455 Lincoln Hwy
Everett, PA 15537-7046

Phone

(814) 623-6161

NPI assigned

Oct 27, 2015

Last updated

Mar 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katelyn.m.black@upmcdirect.com

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.

• Upmc Altoona

  dba Altoona Emergency Physicians

  • General Acute Care Hospital
  • Altoona, PA
  • NPI 1497831655
  Medicare reassignment NPD
• Upmc Altoona Regional Health Services, Inc

  dba Blair Medical Associates

  • Family Medicine Physician
  • Altoona, PA
  • NPI 1396724217
  Medicare reassignment NPD
• Upmc Bedford Memorial

  • Emergency Medicine Physician
  • Everett, PA
  • NPI 1184772113
  Medicare reassignment
• Upmc Altoona

  • Ambulatory Surgical Clinic/Center
  • Altoona, PA
  • NPI 1114926953
  NPD
• Upmc Bedford Memorial

  • Ambulatory Surgical Clinic/Center
  • Everett, PA
  • NPI 1942345467
  NPD

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1104298306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CARSON HEIGHTS DR",
            "city": "DUNCANSVILLE",
            "state": "PA",
            "postal_code": "166356547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10455 LINCOLN HWY",
            "city": "EVERETT",
            "state": "PA",
            "postal_code": "155377046",
            "telephone_number": "814-623-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-27",
        "last_updated": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "katelyn.m.black@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bedford Regional Urology
• Bedford Regional Urology, P.C. (Stephen J. Yanoshak, D.O.)
• Bedford Surgical Associates, Inc.
• Nicole Dawn Beegle, MS
• Elliott Jody Bilofsky, DO
• Susan Black
• Timothy A Black, R.PH.
• Blair Regenerative Medicine LLC
• Dawn M Bowman
• Brande Saad Group-Bedford

• Physician Assistant in Everett, PA
• Providers in Everett, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.