Kathryn Charlotte Anderson Gravenstein, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9108773 Issued in FL

Practice address

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0915

Phone

(813) 978-9700

NPI assigned

Jun 9, 2015

Last updated

Dec 3, 2019By the provider in NPPES

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

Other identifiers 2

Other names 1

• Kathryn Charlotte Anderson Former name

Medicare fee-for-service enrollment

Enrolled in FL

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tallahassee Orthopedic Clinic III PLGroup PAC ID 4284532755, 538 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mease Dunedin Hospital Hospital, Dunedin, FL, CCN 100043

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: kathryn.anderson.1@18802.direct.athenahealth.com
• Direct secure messaging: kgravenstein178760@direct.tgh.org

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.

• Tallahassee Orthopedic Clinic III PL

  dba Tallahassee Orthopedic Clinic

  • Medical Specialty Clinic/Center
  • Tallahassee, FL
  • NPI 1194778050
  Medicare reassignment Care Compare group
• Musculoskeletal Institute Chartered

  dba Florida Orthopaedic Institute

  • Orthopaedic Surgery Physician
  • Temple Terrace, FL
  • NPI 1386639920
  Medicare reassignment
• Musculoskeletal Institute Chartered

  dba Florida Orthopaedic Institute

  • Orthopaedic Surgery Physician
  • Palm Harbor, FL
  • NPI 1588812168
  NPD
• Tallahassee Orthopedic Clinic III, P.L.

  • Durable Medical Equipment & Medical Supplies
  • Panama City Beach, FL
  • NPI 1497617948
  NPD
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD

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

• Trustees of Mease Hospital Inc

  dba Mease Dunedin Hospital

  • General Acute Care Hospital
  • Dunedin, FL
  • NPI 1336125640
  Care Compare affiliation

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1851772438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370915",
            "telephone_number": "813-978-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370915",
            "telephone_number": "813-978-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVENSTEIN",
        "first_name": "KATHRYN",
        "middle_name": "CHARLOTTE ANDERSON",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA9108773",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015355200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "ANDERSON",
            "middle_name": "CHARLOTTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew John Goschke, ATC, CSCS
• Marlene Dupuis Goulart
• Ann M Gowski, NP
• Stephanie Nicole Graham, APRN
• David Edward Grant, MSN, APRN, NP-C
• Darin Lee Graves, LMT
• Michelle Gray
• Christopher William Grayson, M.D.
• Greater Florida Anesthesiologists, LLC
• Marie Greco

• Physician Assistant in Temple Terrace, FL
• Providers in Temple Terrace, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.