Individual provider Active NPI

Katelyn Vasicek, PA-C

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1427415462
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007657 Issued in MI
Practice address
1634 Gull Rd
Kalamazoo, MI 49048-1632
Phone
(269) 903-2835
NPI assigned
Jan 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007657 MI Primary

Addresses

Primary practice location

1634 Gull Rd
Kalamazoo, MI 49048-1632

Mailing address

3724 Lancaster Dr
Kalamazoo, MI 49006-5424
Phone (269) 509-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160209000289 MI Practitioner - Physician Assistant 0941504104 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pic Indiana PCGroup PAC ID 3476790239, 143 clinicians

Practice addresses (Care Compare)

1131 M 32
Alpena, MI 49707-8222
Phone (989) 250-1925

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601007657MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Urgent Care of Michigan, P.C. CurrentSince Jan 8, 2024 Accepting new patients
Hometown Urgent Care of Michigan, PC CurrentSince Jan 8, 2024 Accepting new patients
Bronson Lakeview Hospital CurrentSince Mar 1, 2016 Accepting new patients
Hometown Urgent Care of Michigan, P.C. Current Accepting new patients
Bronson Lakeview Hospital CurrentSince Mar 1, 2016 Accepting new patients
Bronson Methodist Hospital Physician Assistant CurrentSince Mar 1, 2016 Accepting new patients
Physicians Immediate Care LTD Past Accepting new patients

Locations

1131 M 32 W
Alpena, MI 49707
Phone (989) 250-1925

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

601 John St
Ste M-302
Kalamazoo, MI 49007
Phone (269) 276-0000

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

Interoperability endpoints

  • Direct secure messaging: kdarling74859@direct.bronsonhg.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1427415462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 LANCASTER DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490065424",
            "telephone_number": "269-509-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481632",
            "telephone_number": "269-903-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASICEK",
        "first_name": "KATELYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-21",
        "last_updated": "2024-04-17",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.