Individual provider Active NPI

Kaitlyn Alexis Trent, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Newark, DE
National Provider Identifier
1316764160
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C50012123 Issued in DE
Practice address
4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone
(302) 733-1000
NPI assigned
Sep 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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 C0009640 MD
Physician Assistant 363A00000X C50012123 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

Mailing address

102 Amherst Dr
Newark, DE 19711-3124
Phone (302) 545-9942

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250328000919 DE Practitioner - Physician Assistant 3971026170 Reassigns benefits to 1 organization
I20251025000447 MD Practitioner - Physician Assistant 3971026170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

106 Bow St
Elkton, MD 21921-5544
Phone (410) 398-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C50012123DEMDPhysician Assistant
C0009640MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Emergency Physicians LLC Physician Assistant CurrentSince Aug 14, 2025 Accepting new patients

Locations

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1316764160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 AMHERST DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197113124",
            "telephone_number": "302-545-9942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENT",
        "first_name": "KAITLYN",
        "middle_name": "ALEXIS",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009640",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C50012123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.