Individual provider Active NPI

Katelyn Marie Kenderdine, AU.D.

  • Audiologist
  • Lititz, PA
National Provider Identifier
1477035160
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT006581 Issued in PA
Practice address
235 Bloomfield Dr
Lititz, PA 17543-7791
Phone
(717) 925-8856
NPI assigned
Aug 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT006581 PA Primary

Addresses

Primary practice location

235 Bloomfield Dr
Lititz, PA 17543-7791

Mailing address

463 Creekside LN
Lititz, PA 17543-6812
Phone (267) 210-3618

Other practice location 1

2160 Noll Dr Ste 100
Lancaster, PA 17603-7608
Phone (717) 510-1399

Other practice location 2

226 Willow Valley Lakes Dr
Willow Street, PA 17584-9665
Phone (717) 283-4593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181024000577 PA Practitioner - Qualified Audiologist 9234482092 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Physician Associates, LLCGroup PAC ID 6204012016, 43 clinicians
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

2851 Baglyos Cir
Suite 201
Bethlehem, PA 18020-8038
Phone (610) 867-7134

497 Bushkill Plaza LN
Wind Gap, PA 18091-9602
Phone (610) 776-4512

6689 Sullivan TRL
Wind Gap, PA 18091-9790
Phone (610) 954-4960

6695 Sullivan TRL
Suite 201
Wind Gap, PA 18091-9790
Phone (610) 691-3131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT006581PAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physician Associates, LLC CurrentSince Dec 3, 2018 Accepting new patients
A & E Audiology, Inc. Audiologist CurrentSince Aug 25, 2018 Accepting new patients
Specialty Audiology Associates Inc CurrentSince Sep 8, 2021 Accepting new patients

Locations

3445 High Point Blvd
Ste 400
Bethlehem, PA 18017
Phone (610) 824-5050

2851 Baglyos Cir
Ste 201
Bethlehem, PA 18020
Phone (610) 515-1590

619 Dalton St
Rear
Emmaus, PA 18049
Phone (610) 965-1093

2160 Noll Dr
Ste 100
Lancaster, PA 17603
Phone (717) 392-4327

235 Bloomfield Dr
Ste 108
Lititz, PA 17543
Phone (717) 336-8198

226 Willow Valley Lakes Dr
Willow Street, PA 17584
Phone (717) 735-3133

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/76651

Organizations & group practices 4

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": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1477035160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 CREEKSIDE LN",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175436812",
            "telephone_number": "267-210-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 BLOOMFIELD DR",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437791",
            "telephone_number": "717-925-8856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 Noll Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176037608",
            "country_code": "US",
            "telephone_number": "717-510-1399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "226 Willow Valley Lakes Dr",
            "address_purpose": "LOCATION",
            "city": "Willow Street",
            "state": "PA",
            "postal_code": "175849665",
            "country_code": "US",
            "telephone_number": "717-283-4593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENDERDINE",
        "first_name": "KATELYN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT006581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lititz, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.