Individual provider Active NPI

Katherine Sharp

  • Physician Assistant
  • East Brunswick, NJ
National Provider Identifier
1104464247
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00647700 Issued in NJ
Practice address
645 Highway 18
East Brunswick, NJ 08816-3760
Phone
(732) 390-1190
NPI assigned
Dec 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 026920 NY
Physician Assistant 363A00000X 25MP00647700 NJ Primary

Addresses

Primary practice location

645 Highway 18
East Brunswick, NJ 08816-3760

Mailing address

475 Seaview Ave
Staten Island, NY 10305-3436

Other practice location 1

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20211116000424 NJ Practitioner - Physician Assistant 3971992884 Reassigns benefits to 3 organizations
I20221212001835 NY Practitioner - Physician Assistant 3971992884 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00647700NJMDPhysician Assistant
026920NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 16, 2024 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Jun 15, 2025 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Oct 1, 2024 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Jun 15, 2025 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Oct 1, 2024 Accepting new patients

Locations

645 State Route 18
East Brunswick, NJ 08816
Phone (732) 390-1160

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

125 Paterson St
Ste 4100
New Brunswick, NJ 08901
Phone (732) 235-7756

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: ksharp69815@northwell.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1104464247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 HIGHWAY 18",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163760",
            "telephone_number": "732-390-1190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Seaview Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053436",
            "country_code": "US",
            "telephone_number": "718-226-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHARP",
        "first_name": "KATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-19",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026920",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00647700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.