Individual provider Active NPI

Katelynn Adella O'Keefe, PA

  • Medical Physician Assistant
  • Detroit, MI
National Provider Identifier
1265987309
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
6071 W Outer Dr
Detroit, MI 48235-2624
Phone
(313) 966-4800
NPI assigned
Aug 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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 Primary

Addresses

Primary practice location

6071 W Outer Dr
Detroit, MI 48235-2624

Mailing address

1360 Pinecrest Dr
Ferndale, MI 48220-1608
Phone (906) 361-6655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20171018000993 NY Practitioner - Physician Assistant 0042586109 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CS Medical Associates, PCGroup PAC ID 9335401454, 63 clinicians

Practice addresses (Care Compare)

100 Granny Rd
Suite 1
Farmingville, NY 11738-2879
Phone (631) 696-4357

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CS Medical Associates, P.C. CurrentSince May 11, 2024 Accepting new patients

Locations

100 Granny Rd
Farmingville, NY 11738
Phone (631) 698-7828

100 Granny Rd
Ste 1
Farmingville, NY 11738
Phone (631) 666-1234

1377 Motor Pkwy
Ste 102
Islandia, NY 11749

5100 Sunrise Hwy
Fl 2
Massapequa Park, NY 11762
Phone (516) 205-6714

Interoperability endpoints

  • Direct secure messaging: kbitetti@victoryrecovery.medentdirect.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1265987309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 PINECREST DR",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201608",
            "telephone_number": "906-361-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KEEFE",
        "first_name": "KATELYNN",
        "middle_name": "ADELLA",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.