Kaitlyn M Redenius, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9110119 Issued in FL

Practice address

1528 Del Prado Blvd S
Cape Coral, FL 33990-3798

Phone

(239) 458-3338

Fax

(239) 458-0666

NPI assigned

Mar 14, 2017

Last updated

Jan 17, 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 1

Addresses

Other identifiers 2

Other names 1

• Kaitlyn M Baker Former name

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  Medicare reassignment Care Compare group NPD
• Internal Medicine Associates of Lee County Hospitalist Group, LLC

  • Hospitalist Physician
  • Fort Myers, FL
  • NPI 1033402185
  NPD (past)

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

• Lee Health System Inc

  dba Cape Coral Hospital

  • General Acute Care Hospital
  • Cape Coral, FL
  • NPI 1780429076
  Care Compare affiliation

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1255872958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903798",
            "telephone_number": "239-458-3338",
            "fax_number": "239-458-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDENIUS",
        "first_name": "KAITLYN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020904500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA-C",
            "identifier": "PA9110119",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "BAKER",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.