Individual provider Active NPI

Katherine A Lestitian, PA-C

  • Surgical Physician Assistant
  • Morgantown, WV
National Provider Identifier
1427092758
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0528 Issued in WV
Practice address
1 Medical Center Dr
Morgantown, WV 26506
Phone
(304) 293-4180
Fax
(304) 293-5845
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA052238 PA
Surgical Physician Assistant 363AS0400X MA052238 PA
Surgical Physician Assistant 363AS0400X 0528 WV Primary

Addresses

Primary practice location

1 Medical Center Dr
Morgantown, WV 26506

Mailing address

PO Box 9238
Morgantown, WV 26506-9238
Phone (304) 293-4180

Other identifiers 3

IdentifierTypeStateIssuer
1560682OtherPAGATEWAY-WMG
1945153OtherPAHIGHMARK BLUE SHIELD
50067315OtherPACAPITAL BLUE CROSS-WMG

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address klestitian1861@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address klestitian1861@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20060619000037 PA Practitioner - Physician Assistant 2567474372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Physician ServicesGroup PAC ID 6103719562, 106 clinicians

Practice addresses (Care Compare)

155 Wilson Ave
Washington, PA 15301-3336

190 N Main St
Suite 204
Washington, PA 15301-4395
Phone (724) 225-9970

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1525WVMDGerontology Occupational Therapist
MA052238PAMDSurgical Physician Assistant
0528WVMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Physician Services CurrentSince Sep 2, 2021 Accepting new patients

Locations

155 Wilson Ave
Washington, PA 15301
Phone (724) 223-3342

190 N Main St
Ste 204
Washington, PA 15301
Phone (724) 223-9335

125 N Franklin Dr
Ste 1
Washington, PA 15301
Phone (724) 225-6500

Organizations & group practices 1

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 2

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1427092758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9238",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265069238",
            "telephone_number": "304-293-4180",
            "fax_number": "304-293-5845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26506",
            "telephone_number": "304-293-4180",
            "fax_number": "304-293-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESTITIAN",
        "first_name": "KATHERINE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA052238",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA052238",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WV",
            "license": "0528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "1560682",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1945153",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS-WMG",
            "identifier": "50067315",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klestitian1861@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medical Center Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265061200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klestitian1861@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medical Center Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265061200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.