Individual provider Active NPI

Kaitlin Nicole Siddons I

  • Physician Assistant
  • Willow Grove, PA
National Provider Identifier
1790658961
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA067270 Issued in PA
Practice address
2360 Maryland Rd
Willow Grove, PA 19090-1709
Phone
(215) 657-6776
NPI assigned
Sep 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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 MA067270 PA Primary

Addresses

Primary practice location

2360 Maryland Rd
Willow Grove, PA 19090-1709

Mailing address

2360 Maryland Rd
Willow Grove, PA 19090-1709
Phone (215) 657-6776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20251223002856 PA Practitioner - Physician Assistant 7113412420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Jefferson Medical College of Thomas Jefferson University, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2360 Maryland Rd
Willow Grove, PA 19090-1793

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA067270PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rheumatic Disease Associates,LTD CurrentSince Nov 10, 2025 Accepting new patients

Locations

599 W State St
Ste 310
Doylestown, PA 18901
Phone (267) 893-6780

801 Old York Rd
Ste 320
Jenkintown, PA 19046
Phone 2156576776438

1717 Langhorne Newtown Rd
Ste 101
Langhorne, PA 19047

100 Deerfield Ln
Ste 310
Malvern, PA 19355

2360 Maryland Rd
Willow Grove, PA 19090

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kaitlin.siddons.p1@direct.arthritispa.nextgenshare.com

Organizations & group practices 1

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 6

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": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1790658961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 MARYLAND RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901709",
            "telephone_number": "215-657-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 MARYLAND RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901709",
            "telephone_number": "215-657-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDONS",
        "first_name": "KAITLIN",
        "middle_name": "NICOLE",
        "name_suffix": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-24",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA067270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Grove, PA

Sources for this page

Verify at the official NPI Registry.