NPIMap

Individual provider Active NPI

Katelyn Gillespie

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1366310591
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4201 Henry Ave
Philadelphia, PA 19144-5409
Phone
(215) 951-0208
NPI assigned
Oct 28, 2025
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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 NU Primary
Physician Assistant 363A00000X PA.0009537 CO

Addresses

Primary practice location

4201 Henry Ave
Philadelphia, PA 19144-5409

Mailing address

4201 Henry Ave
Philadelphia, PA 19144-5409

Other practice location 1

12905 W 40th Ave Ste 515
Golden, CO 80401-2794
Phone (303) 665-2603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20260121003339 CO Practitioner - Physician Assistant 6204313224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12905 W 40TH Ave
Suite 515
Golden, CO 80401-2794
Phone (303) 665-2603

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0009537COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Centers of Colorado, LLC Physician Assistant CurrentSince Feb 2, 2026 Accepting new patients
Orthopedic Centers of Colorado, LLC Physician Assistant CurrentSince Feb 2, 2026 Accepting new patients

Locations

1411 S Potomac St
Ste 350
Aurora, CO 80012
Phone (303) 671-2134

12905 W 40th Ave
Ste 515
Golden, CO 80401
Phone (303) 456-6000

8101 E Lowry Blvd
Ste 120
Lowry, CO 80230
Phone (303) 806-1998

3 Superior Dr
Ste 225
Superior, CO 80027
Phone 3036652603106

500 W 144th Ave
Ste 230
Westminster, CO 80023
Phone 3036652603 ext. 223

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.

Hospital & facility affiliations 11

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": "1761609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1366310591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 HENRY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191445409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 HENRY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191445409",
            "telephone_number": "215-951-0208"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12905 W 40th Ave Ste 515",
            "address_purpose": "LOCATION",
            "city": "Golden",
            "state": "CO",
            "postal_code": "804012794",
            "country_code": "US",
            "telephone_number": "303-665-2603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "KATELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-28",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0009537",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.