Individual provider Active NPI

Katie N Kandrysawtz, CRNP

  • Family Nurse Practitioner
  • York, PA
National Provider Identifier
1447548193
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP011484 Issued in PA
Practice address
2339 S George St
York, PA 17403-5009
Phone
(717) 812-3040
Fax
(717) 741-3028
NPI assigned
Jul 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP011484 PA Primary

Addresses

Primary practice location

2339 S George St
York, PA 17403-5009

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

1001 S George St
York, PA 17403-3676
Phone (717) 851-3884

Other practice location 2

3065 Windsor Rd
Red Lion, PA 17356-8533
Phone (717) 812-3040

Other practice location 3

2050 S Queen St
York, PA 17403-4829
Phone (717) 812-4240

Other practice location 4

2003 E Market St
York, PA 17402-2841
Phone (717) 812-4242

Other identifiers 2

IdentifierTypeStateIssuer
2659362OtherPAHIGHMARK BLUE SHIELD
1602293OtherPAGATEWAY MEDICARE ASSURED

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
I20110902000021 PA Practitioner - Nurse Practitioner 8628248549 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP011484PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Sep 12, 2011 Accepting new patients
Wellspan Medical Group CurrentSince Sep 12, 2011 Accepting new patients

Locations

3065 Windsor Rd
Red Lion, PA 17356
Phone (717) 812-3040

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

2339 S George St
York, PA 17403
Phone (717) 812-3040

1803 Mount Rose Ave
Ste B3
York, PA 17403
Phone (717) 851-6816

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

2003 E Market St
York, PA 17402
Phone (717) 812-4242

1001 S George St
York, PA 17403
Phone (717) 812-7687

2050 S Queen St
York, PA 17403
Phone (717) 812-2316

Interoperability endpoints

  • Direct secure messaging: kkandrysawtz103080@wellspan.direct-ci.com

Organizations & group practices 3

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": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1447548193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2339 S GEORGE ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035009",
            "telephone_number": "717-812-3040",
            "fax_number": "717-741-3028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 S George St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174033676",
            "country_code": "US",
            "telephone_number": "717-851-3884",
            "fax_number": "717-851-3382",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3065 Windsor Rd",
            "address_purpose": "LOCATION",
            "city": "Red Lion",
            "state": "PA",
            "postal_code": "173568533",
            "country_code": "US",
            "telephone_number": "717-812-3040",
            "fax_number": "717-741-3028",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2050 S Queen St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174034829",
            "country_code": "US",
            "telephone_number": "717-812-4240",
            "fax_number": "717-848-5520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2003 E Market St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174022841",
            "country_code": "US",
            "telephone_number": "717-812-4242",
            "fax_number": "717-755-7569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANDRYSAWTZ",
        "first_name": "KATIE",
        "middle_name": "N",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP011484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "2659362",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY MEDICARE ASSURED",
            "identifier": "1602293",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.