Active NPI
Kaitlynd Nicole Hanna, P.A.
- Physician Assistant
- Lorain, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.008429RX
- Practice address
- 6150 Park Avenue Dr.
Ste. B
Lorain, OH 44053-4153 - Phone
- (440) 984-6499
- Fax
- (234) 757-7545
- NPI assigned
- Apr 19, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50.008429RX | OH | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
6150 Park Avenue Dr.
Ste. B
Lorain, OH 44053-4153
Mailing address
2000 Auburn Dr.
Ste. 350
Beachwood, OH 44122-4327
Phone (440) 646-1600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0036653 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
36855 American Way
Avon, OH 44011-4054
Phone (440) 696-7546
4350 Crocker Rd
Suite 300
Westlake, OH 44145-6329
Phone (440) 646-1600
6150 Park Square Dr
Suite B
Lorain, OH 44053-4153
Phone (440) 984-6499
7580 Auburn Rd
Suite 301
Painesville, OH 44077-9618
Phone (440) 352-7546
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.008429RX | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SCH Professional Corporation | Past | Accepting new patients | |
| Gary R Kutsikovich MD and Associates Inc | Past | Accepting new patients |
Interoperability endpoints
- kbudzik@apexskin.emadirect.md
- kbudzik565451@ehrdirect.uhhospitals.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 and National Provider Directory roles.
-
- Dermatology Physician
- Mayfield Heights, OH
- NPI 1689973638
-
- Neurology Physician
- Mentor, OH
- NPI 1841250420
-
- Family Medicine Physician
- Salem, OH
- NPI 1619959822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761004800000",
"number": "1609563782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 AUBURN DR.",
"address_2": "STE. 350",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441224327",
"telephone_number": "440-646-1600",
"fax_number": "440-646-1505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6150 PARK AVENUE DR.",
"address_2": "STE. B",
"city": "LORAIN",
"state": "OH",
"postal_code": "440534153",
"telephone_number": "440-984-6499",
"fax_number": "234-757-7545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNA",
"first_name": "KAITLYND",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-19",
"last_updated": "2025-10-21",
"certification_date": "2025-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.008429RX",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0036653",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.