NPIMap

Individual provider Active NPI

Katelyn E Willis, PA

  • Medical Physician Assistant
  • Reading, PA
National Provider Identifier
1265735500
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA054647 Issued in PA
Practice address
120 Prospect Street
Reading, PA 19606
Phone
(610) 779-1330
Fax
(610) 779-7699
NPI assigned
Dec 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA054647 PA Primary

Addresses

Primary practice location

120 Prospect Street
Reading, PA 19606

Mailing address

120 Prospect Street
Reading, PA 19606
Phone (610) 779-1330

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110603000299 PA Practitioner - Physician Assistant 7113104928 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pottstown Clinic Company LLCGroup PAC ID 6406857184, 112 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

193 Old Swede Rd
Douglasville, PA 19518-1522
Phone (610) 385-3010

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.71 of 100Reported as group
Quality
73.34
Promoting interoperability
97
Improvement activities
40
Cost
78.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group CurrentSince Apr 8, 2019 Accepting new patients
Tower Health Medical Group CurrentSince Apr 8, 2019 Accepting new patients
Pottstown Hospital Company LLC Past Accepting new patients

Locations

957 Ben Franklin Hwy E
Douglassville, PA 19518
Phone (610) 898-6650

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Organizations & group practices 5

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 9

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": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1265735500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PROSPECT STREET",
            "city": "READING",
            "state": "PA",
            "postal_code": "19606",
            "telephone_number": "610-779-1330",
            "fax_number": "610-779-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PROSPECT STREET",
            "city": "READING",
            "state": "PA",
            "postal_code": "19606",
            "telephone_number": "610-779-1330",
            "fax_number": "610-779-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "KATELYN",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-08",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

Verify at the official NPI Registry.