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Individual provider Active NPI

Katryn Keefer, PA-C

  • Medical Physician Assistant
  • Edwardsville, PA
National Provider Identifier
1639915853
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA065686 Issued in PA
Practice address
75 S Wyoming Ave Ste 2
Edwardsville, PA 18704-3103
Phone
(570) 704-4233
NPI assigned
Jul 8, 2024
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA065686 PA Primary

Addresses

Primary practice location

75 S Wyoming Ave Ste 2
Edwardsville, PA 18704-3103

Mailing address

276 E End Ctr
Wilkes Barre, PA 18702-6970

Other practice location 1

1730 E Broad St
Hazleton, PA 18201-5657
Phone (570) 704-4648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240827000223 PA Practitioner - Physician Assistant 8527507243 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

416 S Main St
Mansfield Laurel Health Center
Mansfield, PA 16933-1510
Phone (570) 662-2002

45 Mud Creek Rd
Troy, PA 16947-9529
Phone (570) 297-3746

6 Riverside PLZ
Blossburg, PA 16912-1137
Phone (570) 638-2174

7 Water St
Wellsboro, PA 16901-1126

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Penn Comprehensive Health Services CurrentSince Jul 28, 2025 Accepting new patients
Rural Health Corporation of Northeastern Pennsylvania CurrentSince Aug 7, 2024 Accepting new patients
Rural Health Corporation of Northeastern Pennsylvania CurrentSince Aug 7, 2024 Accepting new patients
North Penn Comprehensive Health Services CurrentSince Jul 28, 2025 Accepting new patients

Locations

1730 E Broad St
Hazleton, PA 18201
Phone (570) 455-3656

40 W Wellsboro St
Mansfield, PA 16933
Phone (570) 662-1945

26 N Main St
Shickshinny, PA 18655
Phone (570) 542-4141

7 Water St
Wellsboro, PA 16901
Phone (570) 724-1010

276 E End Ctr
Wilkes Barre, PA 18702
Phone (570) 825-8741

Organizations & group practices 6

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 5

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": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1639915853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 E END CTR",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187026970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 S WYOMING AVE STE 2",
            "city": "EDWARDSVILLE",
            "state": "PA",
            "postal_code": "187043103",
            "telephone_number": "570-704-4233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1730 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Hazleton",
            "state": "PA",
            "postal_code": "182015657",
            "country_code": "US",
            "telephone_number": "570-704-4648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEEFER",
        "first_name": "KATRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA065686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, PA

Sources for this page

Verify at the official NPI Registry.