Individual provider Active NPI

Katerina Ruth Lyons, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1487732632
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09655 Issued in NC
Practice address
4414 Lake Boone TRL Ste 205
Raleigh, NC 27607-7514
Phone
(919) 788-4444
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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 0010-09655 NC Primary

Addresses

Primary practice location

4414 Lake Boone TRL Ste 205
Raleigh, NC 27607-7514

Mailing address

4414 Lake Boone TRL Ste 205
Raleigh, NC 27607-7514
Phone (919) 788-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20211013000364 NC Practitioner - Physician Assistant 1759484553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uwh of the Carolinas PLLCGroup PAC ID 0042448169, 329 clinicians

Practice addresses (Care Compare)

1806 S Hawthorne Rd
Winston Salem, NC 27103-4014
Phone (336) 768-3632

4414 Lake Boone TRL
Raleigh, NC 27607-7514

Hospital & facility affiliations

  • Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

Merit-based Incentive Payment System (MIPS)

Final score
88.25 of 100Reported as group
Quality
82.32
Promoting interoperability
100
Improvement activities
40
Cost
78.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18525CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Whap, PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: katerina.lyons.1@7773.direct.athenahealth.com

Organizations & group practices 2

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.

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1487732632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 205",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077514",
            "telephone_number": "919-788-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 205",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077514",
            "telephone_number": "919-788-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "KATERINA",
        "middle_name": "RUTH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.