Individual provider Active NPI

Kaitlin Rashelle Masterson, PA

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1356970776
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TP994 Issued in KY
Practice address
200 Abraham Flexner Way
Louisville, KY 40202-2877
Phone
(502) 569-7983
NPI assigned
Apr 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TP994 KY Primary

Addresses

Primary practice location

200 Abraham Flexner Way
Louisville, KY 40202-2877

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 569-7983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20210104001612 KY Practitioner - Physician Assistant 0446663876 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisville Observational Medicine Associates PSCGroup PAC ID 2860890704, 32 clinicians

Practice addresses (Care Compare)

4000 Kresge Way
Louisville, KY 40207-4605
Phone (502) 897-8100

Hospital & facility affiliations

  • Baptist Health Louisville Hospital, Louisville, KY, CCN 180130

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Dec 14, 2020 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Dec 14, 2020 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

200 Abraham Flexner Way
Louisville, KY 40202
Phone (502) 569-7983

Organizations & group practices 4

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": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1356970776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-569-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ABRAHAM FLEXNER WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022877",
            "telephone_number": "502-569-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERSON",
        "first_name": "KAITLIN",
        "middle_name": "RASHELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TP994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.