Individual provider Active NPI

Kaitlyn Marie Ball, PA-C

  • Physician Assistant
  • Harrisburg, PA
National Provider Identifier
1639699614
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA061912 Issued in PA
Practice address
2808 Old Post Rd
Harrisburg, PA 17110-3685
Phone
(717) 920-4400
NPI assigned
Jun 21, 2017
Last updated
Jul 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X OA004192 PA
Physician Assistant 363A00000X MA061912 PA Primary

Addresses

Primary practice location

2808 Old Post Rd
Harrisburg, PA 17110-3685

Mailing address

2808 Old Post Rd
Harrisburg, PA 17110-3685

Other practice location 1

50 N 39th St
Philadelphia, PA 19104
Phone (215) 662-8000

Other identifiers 1

IdentifierTypeStateIssuer
103333882MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kball55323@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170829001052 PA Practitioner - Physician Assistant 3779856604 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinnacle Health Cardiovascular Institute IncGroup PAC ID 6901087006, 117 clinicians

Practice addresses (Care Compare)

111 S Front St
FL 2
Harrisburg, PA 17101-2010
Phone (717) 731-0101

2020 Technology Pkwy
Suite 201
Mechanicsburg, PA 17050-9411
Phone (717) 731-0101

2808 Old Post Rd
Harrisburg, PA 17110-3685
Phone (717) 920-4400

360 Alexander Spring Rd
Carlisle, PA 17015-9129
Phone (717) 243-6557

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA061912PAMDPhysician Assistant
OA004192PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Nov 9, 2020 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Nov 9, 2020 Accepting new patients

Locations

7133 Roosevelt Blvd
Philadelphia, PA 19149
Phone (215) 333-3311

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1639699614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 OLD POST RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171103685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 OLD POST RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171103685",
            "telephone_number": "717-920-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 N 39th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19104",
            "country_code": "US",
            "telephone_number": "215-662-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALL",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA004192",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103333882",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kball55323@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "2808 Old Post Rd",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171103685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.