Kaitlyn Koutris

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA0600234 Issued in PA

Practice address

5 Bel Air South Pkwy Ste 1535
Bel Air, MD 21015-3816

Phone

(410) 569-0044

NPI assigned

Oct 29, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

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.

• Hanover Pediatric Associates, P.C.

  • Pediatrics Physician
  • Hanover, PA
  • NPI 1891721064
  NPD (past)

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1619444692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BEL AIR SOUTH PKWY STE 1535",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210153816",
            "telephone_number": "410-569-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BEL AIR SOUTH PKWY STE 1535",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210153816",
            "telephone_number": "410-569-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTRIS",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA004651",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA0600234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendi Korn, MS CCC-SLP
• Patricia Koski, CCC SLP
• Elaina Kossoy, LGPC
• Taylor Steven Kothe
• Terrilyn Michele Kotishion, RPH
• Rachel Kozak, CCC-SLP
• Elaine Krajewski, R.N.
• Sabrina Kratz, MD
• Jennifer Kraus, LMSW
• Elizabeth Huller Kregel, LGSW

• Medical Physician Assistant in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.