Individual provider Active NPI

Kaitlin Marie Mitchell, PA-C

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1780128264
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61241654 Issued in WA
Practice address
4800 Sand Point Way NE
Seattle, WA 98105-3901
Phone
(253) 370-2590
NPI assigned
Dec 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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 PA0349 NV
Physician Assistant 363A00000X PA61241654 WA Primary

Addresses

Primary practice location

4800 Sand Point Way NE
Seattle, WA 98105-3901

Mailing address

11823 Olympus Way
Gig Harbor, WA 98332-8068
Phone (253) 370-3590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220314000584 WA Practitioner - Physician Assistant 3678857158 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61241654WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Childrens Hospital CurrentSince Feb 4, 2022 Accepting new patients
Seattle Children'S Hospital CurrentSince Feb 4, 2022 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

Interoperability endpoints

  • Direct secure messaging: kmitchell175001@direct.seattlechildrens.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1482019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1780128264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11823 OLYMPUS WAY",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983328068",
            "telephone_number": "253-370-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "253-370-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KAITLIN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-18",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA0349",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61241654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.