Kaitlyn Marie Paine, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

E-15817 Issued in AR

Practice address

1695 E Rainforest Rd
Fayetteville, AR 72703-5385

Phone

(479) 445-6460

NPI assigned

Mar 30, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other names 1

• Dr. Kaitlyn Marie Alcorn Former name

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Plastic and Reconstructive Surgery

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Roller Weight Loss Institute, Inc.Group PAC ID 0446398770, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rollerweightlossandadvancedsurgery.kaitlynpaine@118248.advancedmd-direct.com
• Direct secure messaging: kpaine23162@washingtonregional.direct-ci.com

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.

• Roller Weight Loss Institute,Inc.

  • Specialist
  • Fayetteville, AR
  • NPI 1073743399

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Roller Weight Loss Institute Inc

  • Surgery Physician
  • Tulsa, OK
  • NPI 1912446741

  Multi-Specialty

  NPD
• New York Bariatric Surgery Group PLLC

  dba Premier Bariatric Surgery, PLLC

  • Specialist
  • Roslyn Heights, NY
  • NPI 1164898821

  Multi-Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Washington Regional Medical Center

  • General Acute Care Hospital
  • Fayetteville, AR
  • NPI 1083609150
  Care Compare affiliation

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1588059430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 E RAINFOREST RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035385",
            "telephone_number": "479-445-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 E RAINFOREST RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035385",
            "telephone_number": "479-445-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAINE",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "25MA11233000",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "CT",
            "license": "69381",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "312382",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AR",
            "license": "E-15817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "ALCORN",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Evren Pacalioglu Tore
• Catherine Padon, LAC
• Amanda Lee Pagan, MHPP
• Elisabeth Pagan
• Pain Management & Rehab Consult
• Kristine Palmer, MD
• Matthew Palmer, DPT
• Kathryn A Panek, MD
• Ralph Christopher Panek, MD
• Robert R. Pang, M.D.

• Plastic Surgery Physician in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Plastic Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.