Individual provider Active NPI

Kaitlyn Koehler, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1134847403
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028432 Issued in NY
Practice address
12 W 21St St FL 6
New York, NY 10010-6914
Phone
(212) 343-2222
NPI assigned
Aug 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 028432 NY Primary

Addresses

Primary practice location

12 W 21St St FL 6
New York, NY 10010-6914

Mailing address

12 W 21St St FL 6
New York, NY 10010-6914
Phone (212) 343-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20231027002372 NY Practitioner - Physician Assistant 2769838697 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028432NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Manhattan Medical Arts, PLLC CurrentSince Aug 1, 2022 Accepting new patients
Montefiore New Rochelle Hospital PastSince Aug 1, 2022 Accepting new patients

Locations

492 6th Ave
New York, NY 10011
Phone (646) 454-9000

Interoperability endpoints

  • Direct secure messaging: kaitlyn.koehler.1@17612.direct.athenahealth.com

Organizations & group practices 3

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": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1134847403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 W 21ST ST FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106914",
            "telephone_number": "212-343-2222",
            "fax_number": "646-455-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 W 21ST ST FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106914",
            "telephone_number": "212-343-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "KAITLYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.