Individual provider Active NPI

Katelyn Bliss Wigderson, PA-C

  • Physician Assistant
  • Ocala, FL
National Provider Identifier
1477374627
Registry record updated Sep 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9119424 Issued in FL
Practice address
4600 SW 46TH CT BLDG 200
Ocala, FL 34474-5708
Phone
(352) 336-6000
Fax
(352) 336-6071
NPI assigned
Oct 21, 2024
Last updated
Sep 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9119424 FL Primary
Medical Physician Assistant 363AM0700X 9119424 FL

Addresses

Primary practice location

4600 SW 46TH CT BLDG 200
Ocala, FL 34474-5708

Mailing address

4500 Newberry Rd
Gainesville, FL 32607-2245
Phone (352) 336-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241121000124 FL Practitioner - Physician Assistant 2860927381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Allergy and Asthma Associates PAGroup PAC ID 7315958089, 7 clinicians

Practice addresses (Care Compare)

5507 S Congress Ave
Suite 140
Atlantis, FL 33462-1139
Phone (561) 965-6685

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9119424FLMDMedical Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788566400000",
    "number": "1477374627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072245",
            "telephone_number": "352-336-6000",
            "fax_number": "352-336-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 SW 46TH CT BLDG 200",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344745708",
            "telephone_number": "352-336-6000",
            "fax_number": "352-336-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGDERSON",
        "first_name": "KATELYN",
        "middle_name": "BLISS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2026-09-05",
        "certification_date": "2026-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9119424",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9119424",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.