Individual provider Active NPI

Kathryn Dianne Herden, PA-C

  • Physician Assistant
  • Oviedo, FL
National Provider Identifier
1750734604
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110990 Issued in FL
Practice address
7560 Red Bug Lake Rd Ste 2048
Oviedo, FL 32765-6591
Phone
(407) 366-8856
Fax
(407) 977-4319
NPI assigned
Jul 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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 PA9110990 FL Primary

Addresses

Primary practice location

7560 Red Bug Lake Rd Ste 2048
Oviedo, FL 32765-6591

Mailing address

7560 Red Bug Lake Rd Ste 2048
Oviedo, FL 32765-6591
Phone (407) 366-8856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180529001000 FL Practitioner - Physician Assistant 8022302751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

8315 Red Bug Lake Rd
Oviedo, FL 32765-6860
Phone (407) 599-6193

Hospital & facility affiliations

  • Adventhealth Home Health Home health agency, Altamonte Springs, FL, CCN 107211
  • Centerwell Home Health Home health agency, Orlando, FL, CCN 107234
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9110990FLMDPhysician Assistant
3823WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Mar 2, 2020 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Mar 2, 2020 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

7560 Red Bug Lake Rd
Ste 2048
Oviedo, FL 32765
Phone (407) 366-8856

Interoperability endpoints

  • Direct secure messaging: kherden73927@adventhealth.direct-ci.com

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 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": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1750734604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7560 RED BUG LAKE RD STE 2048",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656591",
            "telephone_number": "407-366-8856",
            "fax_number": "407-977-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7560 RED BUG LAKE RD STE 2048",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656591",
            "telephone_number": "407-366-8856",
            "fax_number": "407-977-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERDEN",
        "first_name": "KATHRYN",
        "middle_name": "DIANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

Verify at the official NPI Registry.