Kaitlin Raeleen Lange, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.007778RX Issued in OH

Practice address

405 B Washington Jackson Road
Suite 108
Eaton, OH 45320

Phone

(937) 456-8330

NPI assigned

Sep 30, 2022

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Alliance Physicians Inc

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dayton Osteopathic Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1821712068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6845 CASTLEROCK TRL APT C",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454596024",
            "telephone_number": "937-239-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 B WASHINGTON JACKSON ROAD",
            "address_2": "SUITE 108",
            "city": "EATON",
            "state": "OH",
            "postal_code": "45320",
            "telephone_number": "937-456-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "KAITLIN",
        "middle_name": "RAELEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-30",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "50.007778RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007778RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klange641310@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "405 B Washington Jackson Road",
            "address_2": "Suite 108",
            "city": "Eaton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "405 B Washington Jackson Road",
            "address_2": "Suite 108",
            "city": "Eaton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• L&M Products, Inc.
• Lisa Marie Landerer, CPRSS
• Walter Carlos Landerer III
• Rachael Ann Lane
• Timothy Lee Lane
• Amanda Lynn Langenkamp, RN
• Rachel Ann Marie Lanham, LSW
• Kenetta Carlene Lawson, RN
• Suzanne Leah Leach, OD, O.D.
• Cynthia Elaine Lee, CDCA

• Physician Assistant in Eaton, OH
• Providers in Eaton, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.