Kathryn Rebecca Bontrager, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1701 S Creasy LN
Lafayette, IN 47905-4972

Phone

(765) 502-4000

NPI assigned

Jun 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbontrager185170@direct.franciscanalliance.org

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.

• Beacon Medical Group, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1033161617
  Medicare reassignment Care Compare group
• Clarksville Emergency Group, PC

  • Emergency Medicine Physician
  • Corydon, IN
  • NPI 1023487154
  Medicare reassignment
• Pic Indiana PC

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1942546890
  Medicare reassignment
• Beacon Medical Group Inc

  • Anesthesiology Physician
  • Elkhart, IN
  • NPI 1437803285
  NPD
• Beacon Medical Group, Inc.

  • Urgent Care Clinic/Center
  • Granger, IN
  • NPI 1629541784
  NPD

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1588044275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 S CREASY LN",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 S CREASY LN",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054972",
            "telephone_number": "765-502-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONTRAGER",
        "first_name": "KATHRYN",
        "middle_name": "REBECCA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine A Bolsen, HSPP
• Christine D Bolton, O.D.
• Michael Bolton Jr.
• Katherine L Bolyard, PH.D.
• Shelley F Boniello, LMHC
• Florence Bonus
• Derek Booth
• Kara M Booth, RD
• Laura Ann Booth, LCAC
• David Heine Bos, MD, PHD

• Physician Assistant in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.