Katherine Wentworth, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA14249 Issued in TX

Practice address

1900 Scenic Dr Ste 2220
Georgetown, TX 78626-7703

Phone

(512) 819-0132

Fax

(512) 819-9335

NPI assigned

Jul 1, 2021

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Georgetown Pulmonary Associates, P.a.

  • Pulmonary Disease Physician
  • Georgetown, TX
  • NPI 1639300288
  Medicare reassignment

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1265002141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 679706",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752679706",
            "telephone_number": "512-792-4402",
            "fax_number": "512-792-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SCENIC DR STE 2220",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786267703",
            "telephone_number": "512-819-0132",
            "fax_number": "512-819-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTWORTH",
        "first_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candice Weiner-Johnson, MD
• David Weinthal
• Jenni Weiss
• Wellness Bay LLC
• Jessica Leigh Wells, R.D.
• Wesleyan Homes, Inc.
• Wesleyan Homes, Inc.
• Wesleyan Homes, Inc.
• Wesleyan Homes, Inc.
• West Texas Medical Supply

• Physician Assistant in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.