Individual provider Active NPI

Katherine Sedlak, PA-C

  • Physician Assistant
  • Edgewood, KY
National Provider Identifier
1669206553
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3576 Issued in KY
Practice address
560 S Loop Rd
Edgewood, KY 41017-3405
Phone
(859) 301-2663
Fax
(859) 817-7848
NPI assigned
Sep 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA3576 KY Primary
Physician Assistant 363A00000X 50.008960RX OH

Addresses

Primary practice location

560 S Loop Rd
Edgewood, KY 41017-3405

Mailing address

560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663

Other practice location 1

7300 Beechmont Ave
Cincinnati, OH 45230-4119
Phone (513) 232-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241031000898 OH Practitioner - Physician Assistant 9537692355 Reassigns benefits to 2 organizations
I20250109001396 KY Practitioner - Physician Assistant 9537692355 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)

2123 Auburn Ave
Suite 630
Cincinnati, OH 45219-2906
Phone (859) 301-2663

2626 Alexandria Pike
Suite 100
Highland Heights, KY 41076-1530
Phone (859) 301-2663

560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663

7910 Beechmont Ave
Cincinnati, OH 45255-4210
Phone (513) 232-2663

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA3576KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocincy Orthopaedics & Sports Medicine PSC CurrentSince Apr 7, 2025 Accepting new patients
Orthocincy Orthopaedics & Sports Medicine PSC Physician Assistant CurrentSince Apr 7, 2025 Accepting new patients

Locations

2845 Chancellor Dr
Crestview Hills, KY 41017
Phone (859) 341-3412

560 S Loop Rd
Edgewood, KY 41017
Phone (859) 817-3599

2626 Alexandria Pike
Ste 100
Highland Heights, KY 41076
Phone (859) 817-3599

2123 Auburn Ave
Ste 630
Cincinnati, OH 45219
Phone (513) 585-1970

4355 Ferguson Dr
Cincinnati, OH 45245
Phone (513) 221-2663

7910 Beechmont Ave
Cincinnati, OH 45255
Phone (513) 474-8600

Organizations & group practices 3

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 2

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": "1725235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1669206553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173405",
            "telephone_number": "859-301-2663",
            "fax_number": "859-817-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173405",
            "telephone_number": "859-301-2663",
            "fax_number": "859-817-7848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7300 Beechmont Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452304119",
            "country_code": "US",
            "telephone_number": "513-232-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEDLAK",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-02",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA3576",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008960RX",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.