Kathryn Elizabeth Witczak, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00420800 Issued in NJ

Practice address

1825 Rte 35
Wall Township, NJ 07719-3541

Phone

(732) 280-2600

Fax

(848) 469-8933

NPI assigned

Dec 14, 2016

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathryn.witczak.1@2983.direct.athenahealth.com

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.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group NPD
• Friendly Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Teaneck, NJ
  • NPI 1255843876
  Medicare reassignment NPD
• Rwjbh Emergency Medicine Associates, LLC

  • Emergency Medicine Physician
  • Somerset, NJ
  • NPI 1912510041
  Medicare reassignment
• Rwjbh Observation Associates LLC

  • Emergency Medicine Physician
  • Livingston, NJ
  • NPI 1760095806
  Medicare reassignment
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD

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

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1881138576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 TAYLOR LN",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087314540",
            "telephone_number": "862-222-4285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 RTE 35",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077193541",
            "telephone_number": "732-280-2600",
            "fax_number": "848-469-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITCZAK",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-14",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00420800",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00420800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0542474",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Weinstock
• Frances Barbara Weldon, M.A. CCC-SLP
• Well BL Opco LLC
• Evette S Wenzel, MD
• Kevin Wilson, LAC
• Robert William Wood
• William S Wood, DMD
• Natalie S Woszczak, PYS.D
• Vanitha Yadalla, MD
• YMCA of the Jersey Shore

• Medical Physician Assistant in Wall Township, NJ
• Providers in Wall Township, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.