Katherine Marie Crocker, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA4959 Issued in MA

Practice address

170 Morton Street
Jamaica Plain, MA 02130

Phone

(617) 971-3305

Fax

(617) 971-3643

NPI assigned

Aug 29, 2013

Last updated

Oct 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23465/brand/1/csg/1/fhir/r4

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.

• Ali Alsaadi MD & Associates PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1891144895
  NPD (past)

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1386078137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MORTON STREET",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "02130",
            "telephone_number": "617-971-3305",
            "fax_number": "617-971-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MORTON STREET",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "02130",
            "telephone_number": "617-971-3305",
            "fax_number": "617-971-3643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "KATHERINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-29",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA4959",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah P Coyne, CCLS
• Marissa Crasnow
• Jean Crawford, PHD, LMT
• Kathleen M Crehan, LISCW
• Brianne Crocker, M.A.
• Janet McIsaac Cromer, LMHC, RN
• Julie Croteau
• Prentice Crowell
• Francesca Lilliana Crutchfield Stoker, MSW
• Mayra Ivelisse Cruz Polanco, M.D

• Medical Physician Assistant in Jamaica Plain, MA
• Providers in Jamaica Plain, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.