Individual provider Active NPI

Katherine Rose Fry

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1275231532
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9117094 Issued in FL
Practice address
1222 S Orange Ave FL 4
Orlando, FL 32806-1215
Phone
(321) 841-6444
NPI assigned
Feb 16, 2023
Last updated
May 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9117094 FL
Medical Physician Assistant 363AM0700X PA9117094 FL Primary

Addresses

Primary practice location

1222 S Orange Ave FL 4
Orlando, FL 32806-1215

Mailing address

1222 S Orange Ave FL 4
Orlando, FL 32806-1215
Phone (321) 841-6444

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230324000405 FL Practitioner - Physician Assistant 1254705759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Mar 9, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 9, 2023 Accepting new patients

Locations

1920 Don Wickham Dr
Clermont, FL 34711
Phone (352) 243-5891

587 E State Road 434
Longwood, FL 32750
Phone (407) 896-1100

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1222 S Orange Ave
Fl 4
Orlando, FL 32806
Phone (321) 841-7700

3745 11th Cir
Ste 105
Vero Beach, FL 32960
Phone (772) 564-2485

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1275231532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE FL 4",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "321-841-6444",
            "fax_number": "407-650-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE FL 4",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "321-841-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "KATHERINE",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117094",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9117094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.