Individual provider Active NPI

Kate Ashley Mazur, RN, CPNP

  • Pediatric Nurse Practitioner
  • Washington, DC
National Provider Identifier
1205068830
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
PENDING Issued in DC
Practice address
111 Michigan Ave NW
Washington, DC 20010-2916
Phone
(202) 476-5000
NPI assigned
Aug 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 773414 TX
Pediatric Nurse Practitioner 363LP0200X 773414 TX
Pediatric Nurse Practitioner 363LP0200X PENDING DC Primary

Addresses

Primary practice location

111 Michigan Ave NW
Washington, DC 20010-2916

Mailing address

PO Box 744785
Atlanta, GA 30374-4785
Phone (202) 476-5000

Other practice location 1

6621 Fannin St
Suite CCC1510.00
Houston, TX 77030-2303
Phone (832) 822-1060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20220912000334 DC Practitioner - Nurse Practitioner 3274679543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S HospitalGroup PAC ID 0244143170, 212 clinicians

Practice addresses (Care Compare)

111 Michigan Ave NW
Washington, DC 20010-2916
Phone (301) 572-3514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
PENDINGDCMDPediatric Pulmonology Physician
773414TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital CurrentSince Aug 9, 2022 Accepting new patients
Children'S Hospital CurrentSince Aug 9, 2022 Accepting new patients
Children'S Hospital Current Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

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": "1250294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1205068830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744785",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744785",
            "telephone_number": "202-476-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6621 Fannin St",
            "address_2": "Suite CCC1510.00",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302303",
            "country_code": "US",
            "telephone_number": "832-822-1060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZUR",
        "first_name": "KATE",
        "middle_name": "ASHLEY",
        "credential": "RN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-15",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "773414",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "773414",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "DC",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.