NPIMap

Individual provider Active NPI

Kristen Jan Kafer, PA-C

  • Medical Physician Assistant
  • Marysville, WA
National Provider Identifier
1265673891
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MED-PAC-LIC-86814 Issued in MT
Practice address
2901 174TH St NE
Marysville, WA 98271-4743
Phone
(360) 454-1900
Fax
(360) 454-1991
NPI assigned
Mar 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60677484 WA
Physician Assistant 363A00000X 4367 AZ
Physician Assistant 363A00000X 2529 - 023 WI
Medical Physician Assistant 363AM0700X MED-PAC-LIC-86814 MT Primary

Addresses

Primary practice location

2901 174TH St NE
Marysville, WA 98271-4743

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (360) 454-1900

Other practice location 1

15585 NE 24th St
Bellevue, WA 98007-3836
Phone (888) 227-3312

Other identifiers 1

IdentifierTypeStateIssuer
1265673891MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MT2 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
I20161028000922 WA Practitioner - Physician Assistant 1153463005 Reassigns benefits to 1 organization
I20200509000237 MT Practitioner - Physician Assistant 1153463005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Billings ClinicGroup PAC ID 6002993516, 814 clinicians

Practice addresses (Care Compare)

2800 10TH Ave N
Billings, MT 59101-0703
Phone (406) 657-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2529WIMDPhysical Therapy Assistant
4367AZMDPhysician Assistant
PA60677484WAMDPhysician Assistant
2529 - 023WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince Mar 30, 2020 Accepting new patients
Optum Care Washington PLLC CurrentSince Mar 30, 2020 Accepting new patients
Billings Clinic CurrentSince May 1, 2020 Accepting new patients
Billings Clinic CurrentSince May 1, 2020 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

1045 N 30th St
Billings, MT 59101
Phone (406) 238-2501

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

2901 174th St NE
Marysville, WA 98271
Phone (360) 454-1900

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

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 8

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": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1265673891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "360-454-1900",
            "fax_number": "360-454-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 174TH ST NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982714743",
            "telephone_number": "360-454-1900",
            "fax_number": "360-454-1991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15585 NE 24th St",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980073836",
            "country_code": "US",
            "telephone_number": "888-227-3312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAFER",
        "first_name": "KRISTEN",
        "middle_name": "JAN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-11",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60677484",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4367",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2529 - 023",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "MED-PAC-LIC-86814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265673891",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

Verify at the official NPI Registry.