Individual provider Active NPI

Katelyn Elizabeth Simmons, PA-C

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1558734681
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.006384RX Issued in OH
Practice address
7910 Beechmont Ave
Cincinnati, OH 45255-4210
Phone
(513) 232-2663
Fax
(859) 817-7848
NPI assigned
Nov 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2952 KY
Physician Assistant 363A00000X 10003578A IN
Physician Assistant 363A00000X 50.006384RX OH Primary

Addresses

Primary practice location

7910 Beechmont Ave
Cincinnati, OH 45255-4210

Mailing address

560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663

Other practice location 1

560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663

Other practice location 2

8251 Pine Rd Ste 212
Cincinnati, OH 45236-2194
Phone (513) 232-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN, KY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20211206002643 OH Practitioner - Physician Assistant 2365742954 Reassigns benefits to 1 organization
I20220318001573 IN Practitioner - Physician Assistant 2365742954 Reassigns benefits to 1 organization
I20220330002606 KY Practitioner - Physician Assistant 2365742954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10003578AINMDPhysician Assistant
PA2952KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocincy Orthopaedics & Sports Medicine PSC CurrentSince Dec 6, 2021 Accepting new patients
Orthocincy Orthopaedics & Sports Medicine PSC Physician Assistant CurrentSince Dec 6, 2021 Accepting new patients

Locations

605 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 496-8779

560 S Loop Rd
Edgewood, KY 41017
Phone (859) 817-3599

2626 Alexandria Pike
Ste 100
Highland Heights, KY 41076
Phone (859) 817-3599

7910 Beechmont Ave
Cincinnati, OH 45255
Phone (513) 474-8600

8251 Pine Rd
Ste 212
Cincinnati, OH 45236
Phone 5138410222120

4355 Ferguson Dr
Cincinnati, OH 45245
Phone (513) 221-2663

2123 Auburn Ave
Ste 630
Cincinnati, OH 45219
Phone (513) 585-1970

Interoperability endpoints

  • Direct secure messaging: ksimmons2@direct.dmc.org
  • Direct secure messaging: ksimmons369035@direct-prd.stelizabeth.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.

NPI Registry JSON

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

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1558734681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173405",
            "telephone_number": "859-301-2663",
            "fax_number": "859-817-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 BEECHMONT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452554210",
            "telephone_number": "513-232-2663",
            "fax_number": "859-817-7848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 S Loop Rd",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410173405",
            "country_code": "US",
            "telephone_number": "859-301-2663",
            "fax_number": "859-817-7848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8251 Pine Rd Ste 212",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452362194",
            "country_code": "US",
            "telephone_number": "513-232-2663",
            "fax_number": "859-817-7848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "KATELYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-11",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2952",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003578A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006384RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.