Individual provider Active NPI

Kathleen Hynes, PA-C

  • Medical Physician Assistant
  • Washington, DC
National Provider Identifier
1124616149
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA031841 Issued in DC
Practice address
50 Irving St NW
Washington, DC 20310-0001
Phone
(202) 724-8800
NPI assigned
Jan 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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 PA031841 DC Primary

Addresses

Primary practice location

50 Irving St NW
Washington, DC 20310-0001

Mailing address

6102 Traceys Overlook Rd
Tracys Landing, MD 20779-2320
Phone (443) 716-5572

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL none

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA031841DCMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1124616149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6102 TRACEYS OVERLOOK RD",
            "city": "TRACYS LANDING",
            "state": "MD",
            "postal_code": "207792320",
            "telephone_number": "443-716-5572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "203100001",
            "telephone_number": "202-724-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYNES",
        "first_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA031841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "none",
            "affiliation": "N",
            "address_1": "50 Irving St NW",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "203100001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.