Katherine Rae Nettles, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

022924 Issued in NY

Practice address

1000 South Ave
Rochester, NY 14620-2782

Phone

(585) 473-2200

NPI assigned

Jul 19, 2018

Last updated

Apr 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NY, DC, VA3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: knettles1440720@soc.inova.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Unity Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1760421713
  Medicare reassignment NPD
• University Orthopaedic Associates of Rochester

  • Specialist
  • Rochester, NY
  • NPI 1346251758
  Medicare reassignment NPD
• Highland Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1972548568
  Medicare reassignment
• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061

  DC

  Medicare reassignment
• Pediatric Specialists of Virginia, LLC

  • Pediatrics Physician
  • Fairfax, VA
  • NPI 1699119818

  DC

  Medicare reassignment
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC

  Medicare reassignment
• Highland Hospital of Rochester

  • Nephrology Physician
  • Rochester, NY
  • NPI 1043597826
  NPD
• Highland Hospital of Rochester

  dba Highland Hospital Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Rochester, NY
  • NPI 1962725739
  NPD
• The Unity Hospital of Rochester

  dba Unity Physician Services

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1457395766
  NPD
• University Orthopaedic Associates of Rochester

  • Durable Medical Equipment & Medical Supplies
  • Dansville, NY
  • NPI 1912720152
  NPD
• Inova Health Care Services

  dba Inova Juniper Program

  • Multi-Specialty Clinic/Center
  • Fairfax, VA
  • NPI 1669511051
  NPD
• Inova Health Care Services

  dba Inova Blood Donor Services

  • Medical Technologist
  • Sterling, VA
  • NPI 1699655589
  NPD

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1215413521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SOUTH AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202733",
            "telephone_number": "585-473-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SOUTH AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202782",
            "telephone_number": "585-473-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 Willowbrook Office Park",
            "address_purpose": "LOCATION",
            "city": "Fairport",
            "state": "NY",
            "postal_code": "144504202",
            "country_code": "US",
            "telephone_number": "585-586-0790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NETTLES",
        "first_name": "KATHERINE",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "22924",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "022924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knettles147008@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knettles147008@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tineshian Nesmith
• John Carmen Nespeca, PHARMD
• Caroline S. Nestro, APRN, BC
• Molly Searl Netherwood
• Joshua Charles Netkin, FNP
• Milan S Nettles, LPN
• Thomas R Nettles, RPH
• Kara M. Nettnin
• Kelly Lynn Nettnin
• Lisa Neu-Posadni

• Medical Physician Assistant in Rochester, NY
• Providers in Rochester, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.