NPIMap

Individual provider Active NPI

Mark Otis Catron, PAC

  • Medical Physician Assistant
  • Berea, KY
National Provider Identifier
1811933989
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA144 Issued in KY
Practice address
133 Plaza Dr Ste 3
Berea, KY 40403-2087
Phone
(859) 986-1370
Fax
(859) 986-1374
NPI assigned
Jun 20, 2006
Last updated
Mar 26, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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 PA144 KY Primary

Addresses

Primary practice location

133 Plaza Dr Ste 3
Berea, KY 40403-2087

Mailing address

133 Plaza Dr Ste 3
Berea, KY 40403-2087
Phone (859) 986-1370

Other identifiers 2

IdentifierTypeStateIssuer
95002697MedicaidKY
970026471OtherKYRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040128000109 KY Practitioner - Physician Assistant 1658274758 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Laser Center LLCGroup PAC ID 9830238823, 2 clinicians
H2 Rehabilitation Services of Kentucky, LLCGroup PAC ID 5799682688, shared by 7 NPIs, 187 clinicians

Practice addresses (Care Compare)

133 Plaza Dr
Berea, KY 40403-2087
Phone (859) 986-1370

193 Glades Rd
Berea, KY 40403-2261
Phone (859) 956-1055

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA144KYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Strauss Family Practice, LLC Past Accepting new patients
Marshall Emergency Services Associates, PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: markcatron@bucl-ky.direct.office.nextgen.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1811933989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 PLAZA DR STE 3",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404032087",
            "telephone_number": "859-986-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 PLAZA DR STE 3",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404032087",
            "telephone_number": "859-986-1370",
            "fax_number": "859-986-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATRON",
        "first_name": "MARK",
        "middle_name": "OTIS",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95002697",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970026471",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, KY

Sources for this page

Verify at the official NPI Registry.