Individual provider Active NPI

Kaitlin Marie Raidna, PA-C

  • Medical Physician Assistant
  • Somerset, PA
National Provider Identifier
1720727449
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
5706 Glades Pike
Somerset, PA 15501-8302
Phone
(814) 444-1308
NPI assigned
Jun 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 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 Primary

Addresses

Primary practice location

5706 Glades Pike
Somerset, PA 15501-8302

Mailing address

5706 Glades Pike
Somerset, PA 15501-8302
Phone (814) 444-1308

Other practice location 1

111 Loder St
Hornell, NY 14843-1950
Phone (607) 324-5404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20221101000478 NY Practitioner - Physician Assistant 5890161061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Aug 22, 2022 Accepting new patients
Western New York Medical Practice, P.C. CurrentSince Aug 22, 2022 Accepting new patients

Locations

111 Loder St
Hornell, NY 14843
Phone (315) 412-1117

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1720727449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5706 GLADES PIKE",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "155018302",
            "telephone_number": "814-444-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5706 GLADES PIKE",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "155018302",
            "telephone_number": "814-444-1308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Loder St",
            "address_purpose": "LOCATION",
            "city": "Hornell",
            "state": "NY",
            "postal_code": "148431950",
            "country_code": "US",
            "telephone_number": "607-324-5404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAIDNA",
        "first_name": "KAITLIN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, PA

Sources for this page

Verify at the official NPI Registry.