Individual provider Active NPI

Kate Dominique Kasperski, PA-C

  • Physician Assistant
  • Jupiter, FL
National Provider Identifier
1154084952
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
641 University Blvd Ste 211
Jupiter, FL 33458-2794
Phone
(561) 253-8121
NPI assigned
Oct 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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 Primary

Addresses

Primary practice location

641 University Blvd Ste 211
Jupiter, FL 33458-2794

Mailing address

641 University Blvd Ste 211
Jupiter, FL 33458-2794
Phone (561) 253-8121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211116001790 FL Practitioner - Physician Assistant 6800285644

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1154084952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 UNIVERSITY BLVD STE 211",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582794",
            "telephone_number": "561-253-8121",
            "fax_number": "561-253-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 UNIVERSITY BLVD STE 211",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582794",
            "telephone_number": "561-253-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASPERSKI",
        "first_name": "KATE",
        "middle_name": "DOMINIQUE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.