NPIMap

Individual provider Active NPI

Kaitlyn L Kolarik, ARNP

  • Family Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1245964790
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61428516 Issued in WA
Practice address
1717 S J St
Tacoma, WA 98405-4933
Phone
(253) 426-4000
Fax
(253) 428-8440
NPI assigned
Jul 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0031748 OH
Family Nurse Practitioner 363LF0000X AP61428516 WA Primary

Addresses

Primary practice location

1717 S J St
Tacoma, WA 98405-4933

Mailing address

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-4000

Other identifiers 1

IdentifierTypeStateIssuer
2265689MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220829001907 OH Practitioner - Nurse Practitioner 1850775693 Reassigns benefits to 1 organization
I20231127002074 WA Practitioner - Nurse Practitioner 1850775693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141
  • Highline Medical Center Hospital, Burien, WA, CCN 500011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0031748OHMDFamily Nurse Practitioner
AP61428516WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System CurrentSince Jul 11, 2022 Accepting new patients
The Metrohealth System CurrentSince Jul 11, 2022 Accepting new patients
Franciscan Medical Group Current Accepting new patients
The Metrohealth System Current Accepting new patients
Franciscan Medical Group CurrentSince Nov 6, 2023 Accepting new patients
Franciscan Medical Group CurrentSince Nov 6, 2023 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

2500 Metrohealth Dr
#A107
Cleveland, OH 44109

34515 9th Ave S
#136
Federal Way, WA 98003

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

11567 Canterwood Blvd
Gig Harbor, WA 98332
Phone (253) 530-2000

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

1717 S J St
#2010
Tacoma, WA 98405

11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711

Interoperability endpoints

  • Direct secure messaging: kkolarik53455@direct.metrohealth.org

Organizations & group practices 7

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1245964790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-4000",
            "fax_number": "253-428-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-4000",
            "fax_number": "253-428-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLARIK",
        "first_name": "KAITLYN",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0031748",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61428516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2265689",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.