Katrina Marie Robertson, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA.2163 Issued in AL

Practice address

8832 US Highway 90
Daphne, AL 36526-8932

Phone

(251) 263-9820

Fax

(251) 263-9821

NPI assigned

Jul 24, 2021

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

Medicare fee-for-service enrollment

Enrolled in AL

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

University of South Alabama College of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aqua Dermatology of Alabama PCGroup PAC ID 9436211463, 42 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kgarofano@aldermatology.emadirect.md

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.

• Aqua Dermatology of Alabama PC

  • MOHS-Micrographic Surgery Physician
  • Vestavia HLS, AL
  • NPI 1477708642
  Medicare reassignment Care Compare group
• Cutaneous Oncology & Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Vestavia HLS, AL
  • NPI 1699139915
  NPD (past)
• West Florida Medical Center Clinic PA

  • Ambulatory Surgical Clinic/Center
  • Pensacola, FL
  • NPI 1043396245
  NPD (past)

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

{
    "created_epoch": "1627084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1801469028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146050",
            "telephone_number": "850-474-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8832 US HIGHWAY 90",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365268932",
            "telephone_number": "251-263-9820",
            "fax_number": "251-263-9821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Midtown Park E",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366064140",
            "country_code": "US",
            "telephone_number": "251-263-1786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KATRINA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-24",
        "last_updated": "2024-01-03",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA.2163",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116559",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Layne Richardson, PA
• Alan Shawn Ridenoure, M.ED., ATC/L, CSCS
• Leigh Ann Riley
• Rebecca Roberts, CRNP
• Robert Roberts III, RPH
• Jessica Johnson Robinson, D.M.D
• Kenneth Alan Robinson, DC
• Sonya Robinson
• Elizabeth Dalesandro Robson, OD
• Cesar M Roca Jr., MD

• Medical Physician Assistant in Daphne, AL
• Providers in Daphne, AL by specialty
• Medical Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.