Individual provider Active NPI

Katherine Rae Kuluz, PA-C

  • Physician Assistant
  • Pascagoula, MS
National Provider Identifier
1649871682
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00512 Issued in MS
Practice address
3101 Denny Ave Ste 210
Pascagoula, MS 39581-5307
Phone
(288) 095-3552
NPI assigned
Nov 5, 2020
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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 PA00512 MS Primary

Addresses

Primary practice location

3101 Denny Ave Ste 210
Pascagoula, MS 39581-5307

Mailing address

735 Buddelia CV
Biloxi, MS 39532-4118

Other names 1

  • Katherine Rae Herndon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20210106001448 MS Practitioner - Physician Assistant 0840603189 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singing River Health SystemGroup PAC ID 3870405194, 290 clinicians

Practice addresses (Care Compare)

2809 Denny Ave
Pascagoula, MS 39581-5301
Phone (228) 818-0563

2819 Denny Ave
Pascagoula, MS 39581-5301
Phone (228) 762-3466

3101 Denny Ave
Pascagoula, MS 39581-5307
Phone (228) 460-4180

7001 Hwy 614
Coastal Ambulatory Services
Hurley, MS 39555-5340
Phone (228) 588-6622

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA00512MSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Health System CurrentSince Nov 1, 2021 Accepting new patients
Singing River Gulfport CurrentSince Nov 1, 2021 Accepting new patients
Singing River Health System Past Accepting new patients

Locations

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

2525 Telephone Rd
Pascagoula, MS 39567
Phone (228) 762-4483

3101 Denny Ave
Ste 210
Pascagoula, MS 39581
Phone (228) 769-0178

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 3

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": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1649871682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 BUDDELIA CV",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395324118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 DENNY AVE STE 210",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815307",
            "telephone_number": "288-095-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULUZ",
        "first_name": "KATHERINE",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-05",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "HERNDON",
            "middle_name": "RAE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pascagoula, MS

Sources for this page

Verify at the official NPI Registry.