Kaitlyn Marie Rauwerdink, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2 Saint Vincent Cir FL 6
Little Rock, AR 72205-5423

Phone

(501) 265-0619

NPI assigned

Jan 31, 2018

Last updated

Mar 17, 2018By 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 1

Addresses

Other names 1

• Kaitlyn Marie Molter Former name

Medicare fee-for-service enrollment

Enrolled in AR, WI2 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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Oak Medical SCGroup PAC ID 0042595175, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Family Memorial Hospital, Manitowoc, WI, CCN 520107

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Oak Medical SC

  • Internal Medicine Physician
  • Waukesha, WI
  • NPI 1669910345
  Medicare reassignment Care Compare group NPD
• Maple Medical SC

  • Physical Medicine & Rehabilitation Physician
  • Waukesha, WI
  • NPI 1487152104
  Medicare reassignment NPD
• Hospital Medicine

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1396284105
  Medicare reassignment
• Sadiq and Rainosek PLLC

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1669109633
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holy Family Memorial Inc

  dba Froedtert Holy Family Memorial Hospital

  • General Acute Care Hospital
  • Manitowoc, WI
  • NPI 1700998697
  Care Compare affiliation

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1417455817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6412 PAWNEE DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721165790",
            "telephone_number": "920-980-4672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SAINT VINCENT CIR FL 6",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055423",
            "telephone_number": "501-265-0619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Wildwood Ave",
            "address_purpose": "LOCATION",
            "city": "Sherwood",
            "state": "AR",
            "postal_code": "721205074",
            "country_code": "US",
            "telephone_number": "501-834-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Saint Vincent Cir",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722055423",
            "country_code": "US",
            "telephone_number": "501-552-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAUWERDINK",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "MOLTER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jordan Rath, DO
• Peyton Rather
• Aryssa Rathfon
• Christian A Ratzlaff, DO
• Arbind Kumar Raut
• Navya Chetankumar Raval, M.B.B.S.
• Pratheepa Ravikumar, MD
• Srilakshmi Ravula, MD
• Lisa Jane Rawlins, PHARM D
• Clarence E. Rawls, LPE

• Physician Assistant in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.