Individual provider Active NPI

Katie Hewlett

  • Physician Assistant
  • Dayton, OH
National Provider Identifier
1629552609
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.05642RX Issued in OH
Practice address
30 E Apple St Ste 5253
Dayton, OH 45409-2939
Phone
(937) 208-2552
NPI assigned
Sep 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.05642RX OH Primary

Addresses

Primary practice location

30 E Apple St Ste 5253
Dayton, OH 45409-2939

Mailing address

725 University Blvd
Beavercreek, OH 45324-2640
Phone (937) 245-7100

Other practice location 1

2350 Miami Valley Dr Ste 300
Centerville, OH 45459-4778
Phone (937) 438-8640

Other practice location 2

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 702-4450

Other identifiers 1

IdentifierTypeStateIssuer
50.005642RXOtherOHLICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address khewlett578133@direct.ketteringhealth.org
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181005001845 OH Practitioner - Physician Assistant 2062764889 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722

450 N Hyatt St
Suite 304
Tipp City, OH 45371-1433
Phone (937) 832-4773

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.17 of 100Reported as group
Quality
65.6
Promoting interoperability
100
Improvement activities
40
Cost
74.7

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.05642RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Apr 9, 2021 Accepting new patients
Premier Health Specialists Inc Physician Assistant CurrentSince Apr 9, 2021 Accepting new patients
Alliance Physicians Inc CurrentSince Dec 1, 2021 Accepting new patients
Alliance Physicians Inc CurrentSince Dec 1, 2021 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients
Wright State Physicians Inc Past Accepting new patients

Locations

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

2350 Miami Valley Dr
Ste 300
Centerville, OH 45459
Phone (937) 438-8640

30 E Apple St
Ste 5253
Dayton, OH 45409
Phone (937) 208-2552

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1629552609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 UNIVERSITY BLVD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "453242640",
            "telephone_number": "937-245-7100",
            "fax_number": "937-245-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E APPLE ST STE 5253",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092939",
            "telephone_number": "937-208-2552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2350 Miami Valley Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454594778",
            "country_code": "US",
            "telephone_number": "937-438-8640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Pentagon Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "937-702-4450",
            "fax_number": "937-702-4459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEWLETT",
        "first_name": "KATIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.05642RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "50.005642RX",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khewlett578133@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3535 Pentagon Blvd",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454311705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "3535 Pentagon Blvd",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454311705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.