Individual provider Active NPI

Katherine Prevas, PA-C

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1801177670
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0004541 Issued in MD
Practice address
301 St. Paul Place
ER Dept.
Baltimore, MD 21202-2102
Phone
(410) 332-9809
NPI assigned
Sep 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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 C0004541 MD Primary

Addresses

Primary practice location

301 St. Paul Place
ER Dept.
Baltimore, MD 21202-2102

Mailing address

301 St. Paul Place
Medical Staff Office
Baltimore, MD 21202-2102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111017000180 MD Practitioner - Physician Assistant 5193997112 Reassigns benefits to 5 organizations
I20170519001412 DC Practitioner - Physician Assistant 5193997112 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as group
Quality
80.29
Promoting interoperability
100
Improvement activities
40
Cost
75.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0004541MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
WHC Emerg Phys CurrentSince Mar 1, 2020 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2020 Accepting new patients
MNR Industries, LLC CurrentSince Mar 28, 2017 Accepting new patients
Medstar Urgent Care LLC CurrentSince Dec 1, 2020 Accepting new patients
MNR Industries LLC Current Accepting new patients
Medstar Urgent Care LLC CurrentSince Dec 1, 2020 Accepting new patients
MNR Industries,LLC CurrentSince Feb 3, 2017 Accepting new patients
St Paul Place Specialists Inc CurrentSince Feb 16, 2017 Accepting new patients
WHC Physician Group LLC CurrentSince Mar 1, 2020 Accepting new patients
MNR Industries, LLC CurrentSince Feb 3, 2017 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

301 Saint Paul St
Baltimore, MD 21202
Phone (410) 385-4930

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1801177670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ST. PAUL PLACE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ST. PAUL PLACE",
            "address_2": "ER DEPT.",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102",
            "telephone_number": "410-332-9809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREVAS",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0004541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.