Katherine Anne Wiedenhofer, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9104868 Issued in FL

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-3003

Phone

(352) 265-0301

NPI assigned

Jan 13, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: katherine.wiedenhofer@wellmed.eclinicaldirectplus.com

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.

• Optumcare Florida LLC

  • General Practice Physician
  • Tampa, FL
  • NPI 1053384214
  Medicare reassignment Care Compare group NPD
• Optumcare Florida, LLC

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1659884294
  NPD

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238630400000",
    "number": "1366689317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328918025",
            "telephone_number": "352-265-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDENHOFER",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-13",
        "last_updated": "2009-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Ann Wicksell
• Holly Widell, PHARMD
• Charles Glenn Widmer, D.D.S., M.S.
• Jonathan David Wiebold, L.D.O.
• Bret N Wiechmann, MD
• Ashley Brooke Wiegand, CCC-SLP
• Amy Wiemers
• Brenda Ann Wiens, PHD
• Klaas J Wierenga, MD
• Steven Alexander Wietrzykowski, PT, DPT, CSCS

• Medical Physician Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.