Individual provider Active NPI

Katelyn Marie Milanak, PA-C

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1487337515
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4515 Coors Blvd NW
Albuquerque, NM 87120-3699
Phone
(505) 596-2200
Fax
(505) 596-2280
NPI assigned
Aug 7, 2023
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4515 Coors Blvd NW
Albuquerque, NM 87120-3699

Mailing address

1606 Leona Ave
South Park, PA 15129-9731
Phone (412) 651-5399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20240118002330 NM Practitioner - Physician Assistant 3971955691 Reassigns benefits to 1 organization

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
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

4515 Coors Blvd NW
Albuquerque, NM 87120-3699
Phone (505) 596-2200

6400 Paseo del Norte NE
Albuquerque, NM 87113-1718
Phone (505) 596-2100

8300 Constitution Ave NE
Albuquerque, NM 87110-7613

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Jan 17, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince Jan 17, 2024 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

4515 Coors Blvd NW
Albuquerque, NM 87120
Phone (505) 596-2200

6400 Paseo del Norte NE
Albuquerque, NM 87113
Phone (505) 596-2100

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

8312 Kaseman Ct NE
Albuquerque, NM 87110
Phone (505) 291-2200

2400 Unser Blvd SE
Rio Rancho, NM 87124
Phone (505) 253-0000

Interoperability endpoints

  • Direct secure messaging: kmilanak244508@direct.phs.org

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

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": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1487337515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 LEONA AVE",
            "city": "SOUTH PARK",
            "state": "PA",
            "postal_code": "151299731",
            "telephone_number": "412-651-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 COORS BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871203699",
            "telephone_number": "505-596-2200",
            "fax_number": "505-596-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILANAK",
        "first_name": "KATELYN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.