Katie Lynn Wysocki, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0550031179 Issued in VT

Practice address

140 Hospital Dr Ste 108
Bennington, VT 05201-5010

Phone

(802) 447-5519

NPI assigned

Jul 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VT

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

Specialty

Physician Assistant

Education

Albany Medical College of Union University, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwestern Vermont Medical Center, IncGroup PAC ID 0143138446, shared by 3 NPIs, 174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vna & Hospice of the Southwest Region, Inc. Home health agency, Rutland, VT, CCN 477007
• Southwestern Vermont Medical Center Hospital, Bennington, VT, CCN 470012
• North Adams Regional Hospital Corporation Hospital, North Adams, MA, CCN 221304
• Berkshire Medical Center Hospital, Pittsfield, MA, CCN 220046

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Southwestern Vermont Medical Center Inc.

  • Internal Medicine Physician
  • Bennington, VT
  • NPI 1184994162
  Medicare reassignment NPD
• Southwestern Vermont Medical Center Inc.

  • General Acute Care Hospital
  • Bennington, VT
  • NPI 1205865789
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southwestern Vermont Medical Center Inc.

  • General Acute Care Hospital
  • Bennington, VT
  • NPI 1205865789
  Care Compare affiliation
• Vna & Hospice of the Southwest Region, Inc

  • Home Health Agency
  • Rutland, VT
  • NPI 1407856800
  Care Compare affiliation
• Vna & Hospice of the Southwest Region, Inc.

  • Public Health or Welfare Agency
  • Rutland, VT
  • NPI 1578743621

  Home health agency

  Care Compare affiliation
• Berkshire Medical Center, Inc

  • General Acute Care Hospital
  • Pittsfield, MA
  • NPI 1295765261
  Care Compare affiliation
• North Adams Regional Hospital Corporation

  • Critical Access Hospital
  • North Adams, MA
  • NPI 1437839669
  Care Compare affiliation

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1740592617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 HOSPITAL DR",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052015009",
            "telephone_number": "802-447-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 HOSPITAL DR STE 108",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052015010",
            "telephone_number": "802-447-5519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 The Knolls",
            "address_purpose": "LOCATION",
            "city": "Williamstown",
            "state": "MA",
            "postal_code": "012672862",
            "country_code": "US",
            "telephone_number": "413-597-2206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYSOCKI",
        "first_name": "KATIE",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA100218",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VT",
            "license": "0550031179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03349671",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard A Wiseman, MD
• Rachel E. Wolgemuth, PT
• Women's View Midwifery
• Ronald S Woodworth, DO
• Susan Williams Wright, LICSW
• Yankee Medical Inc
• Joanne Yankura, CRNA
• Brandi Yerdon
• Aaron York, MD
• Jeffery A Yucht, MD

• Medical Physician Assistant in Bennington, VT
• Providers in Bennington, VT by specialty
• Medical Physician Assistant in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.