NPIMap

Individual provider Active NPI

Kaitlyn Junko Roberts, PA-S

  • Physician Assistant
  • Sugarloaf, PA
National Provider Identifier
1114608338
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA065227 Issued in PA
Practice address
642 State Route 93 Hwy
Sugarloaf, PA 18249
Phone
(570) 788-6363
NPI assigned
Jul 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X MA065227 PA Primary

Addresses

Primary practice location

642 State Route 93 Hwy
Sugarloaf, PA 18249

Mailing address

2100 Mack Blvd
4TH Floor
Allentown, PA 18103
Phone (484) 884-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20231213000071 PA Practitioner - Physician Assistant 8426407651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

2100 Mack Blvd
FL 4
Allentown, PA 18103-5622

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.5 of 100Reported as group
Quality
66.14
Promoting interoperability
85
Improvement activities
40
Cost
74.44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Hazleton Professional Services CurrentSince Dec 11, 2023 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients

Locations

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

2100 Mack Blvd
Fl 4
Allentown, PA 18103

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

642 State Route 93 Hwy
Sugarloaf, PA 18249
Phone (570) 708-1505

Interoperability endpoints

  • Direct secure messaging: kroberts689713@direct2.lvhn.org

Organizations & group practices 4

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": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1114608338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD",
            "address_2": "4TH FLOOR",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18103",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 STATE ROUTE 93 HWY",
            "city": "SUGARLOAF",
            "state": "PA",
            "postal_code": "18249",
            "telephone_number": "570-788-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KAITLYN",
        "middle_name": "JUNKO",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA065227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugarloaf, PA

Sources for this page

Verify at the official NPI Registry.