Active NPI
Kassia Rose Fortuna, PA-C
- Physician Assistant
- Houston, TX
National Provider Identifier
1811145873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA08840
- Practice address
- 1515 Holcombe Blvd
Houston, TX 77030-4009 - Phone
- (713) 792-6161
- NPI assigned
- Sep 3, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50.002798 | OH | |
| Physician Assistant | 363A00000X | PA08840 | TX | Primary |
Addresses
Primary practice location
1515 Holcombe Blvd
Houston, TX 77030-4009
Mailing address
PO Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 351018201 | Medicaid | TX |
Other names 1
- Kassia Rose Knudson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.002798 | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Cincinnati Physicians Company, LLC | Physician Assistant | Past | Accepting new patients |
| University of Cincinnati Physicians, Inc. | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Cincinnati, OH
- NPI 1801840434
Physician Assistant
-
- Internal Medicine Physician
- Cincinnati, OH
- NPI 1417108697
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449705600000",
"number": "1811145873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4439",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772104439",
"telephone_number": "713-792-2991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 HOLCOMBE BLVD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770304009",
"telephone_number": "713-792-6161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTUNA",
"first_name": "KASSIA",
"middle_name": "ROSE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-03",
"last_updated": "2015-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.002798",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA08840",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "351018201",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KASSIA",
"last_name": "KNUDSON",
"middle_name": "ROSE",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.