Kathleen Egner, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

009564 Issued in NY

Practice address

1300 Roanoke Ave
Radiology Department
Riverhead, NY 11901-2031

Phone

(631) 548-6156

NPI assigned

Jan 19, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

State University of New York at Stony Brook, School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Medical Wellness PCGroup PAC ID 6709128697, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Community Medical Wellness PC

  • Pain Medicine Physician
  • Port Jefferson Station, NY
  • NPI 1073002473
  Medicare reassignment Care Compare group
• John T. Mather Memorial Hospital

  • Psychiatry Physician
  • Port Jefferson Station, NY
  • NPI 1376642371
  Medicare reassignment
• John T. Mather Memorial Hospital

  • Diagnostic Radiology Physician
  • Port Jefferson, NY
  • NPI 1336428796
  NPD
• John T. Mather Memorial Hospital

  • Critical Care Medicine (Internal Medicine) Physician
  • Port Jefferson, NY
  • NPI 1467249334
  NPD

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1841343324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WALBRIDGE AVE",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ROANOKE AVE",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012031",
            "telephone_number": "631-548-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGNER",
        "first_name": "KATHLEEN",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastern Suffolk Nephrology, PC
• Eastern Suffolk Pulmonology,PC
• Eastside Orthotics & Prosthetics, Inc
• Carrie Ann Edington, LMHC
• Jeremiah Carrol Edington, RPA-C
• Dahlia El-Matary, RD
• Rachael Elizabeth Elio, PA
• Raymond S Ellis, ATC
• Judy Ann Emanuele, M.D.
• Emk Quality Care Inc

• Physician Assistant in Riverhead, NY
• Providers in Riverhead, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.