NPIMap

Individual provider Active NPI

Julia Hetrick, PAC

  • Physician Assistant
  • Kutztown, PA
National Provider Identifier
1881472884
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA064893 Issued in PA
Practice address
15065 Kutztown Rd
Kutztown, PA 19530-9220
Phone
(484) 822-8001
Fax
(484) 822-8002
NPI assigned
Sep 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA064893 PA Primary

Addresses

Primary practice location

15065 Kutztown Rd
Kutztown, PA 19530-9220

Mailing address

15065 Kutztown Rd
Kutztown, PA 19530-9220
Phone (484) 822-8001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20231026002443 PA Practitioner - Physician Assistant 9537515580 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA064893PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital Monroe Campus CurrentSince Oct 30, 2023 Accepting new patients
St. Luke'S Quakertown Hospital CurrentSince Oct 30, 2023 Accepting new patients
The Carbon Schuylkill Community Hospital, Inc. CurrentSince Oct 30, 2023 Accepting new patients
St Luke'S Hospital CurrentSince Oct 30, 2023 Accepting new patients
St. Luke'S Hosptial CurrentSince Oct 30, 2023 Accepting new patients
The Carbon Schuylkill Community Hospital, Inc. CurrentSince Oct 30, 2023 Accepting new patients
St. Luke'S Hospital - Anderson Campus CurrentSince Oct 30, 2023 Accepting new patients
St. Luke'S Quakertown Hospital CurrentSince Oct 30, 2023 Accepting new patients
GSL Hospital CurrentSince Oct 30, 2023 Accepting new patients
St. Luke'S Hospital CurrentSince Oct 30, 2023 Accepting new patients

Locations

111 Route 715
Brodheadsvlle, PA 18322
Phone (272) 212-0420

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

1104 North St
Jim Thorpe, PA 18229
Phone (570) 325-2400

15065 Kutztown Rd
Kutztown, PA 19530
Phone (484) 822-8001

2650 Woodglen Rd
Pottsville, PA 17901
Phone (272) 639-5755

487 E Moorestown Rd
Wind Gap, PA 18091
Phone (484) 526-7850

Interoperability endpoints

  • Direct secure messaging: julia.hetrick@slpg.direct-sluhn.org

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 6

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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Luke'S Hospital 100 clinicians

Practice addresses (Care Compare)

1104 N St
St Luke'S Care Now
Jim Thorpe, PA 18229-1717
Phone (570) 325-2400

15065 Kutztown Rd
Kutztown, PA 19530-9276
Phone (484) 822-8001

2701 Shillington Rd
Suite 100
Reading, PA 19608-1732
Phone (484) 822-6170

60 Cherry St
Suite 210
Leesport, PA 19533-8503
Phone (484) 526-4000

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049

NPI Registry JSON

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1881472884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15065 KUTZTOWN RD",
            "city": "KUTZTOWN",
            "state": "PA",
            "postal_code": "195309220",
            "telephone_number": "484-822-8001",
            "fax_number": "484-822-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15065 KUTZTOWN RD",
            "city": "KUTZTOWN",
            "state": "PA",
            "postal_code": "195309220",
            "telephone_number": "484-822-8001",
            "fax_number": "484-822-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETRICK",
        "first_name": "JULIA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA064893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kutztown, PA

Sources for this page

Verify at the official NPI Registry.