Kaitlin Moffett Brandstadter, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD454747 Issued in PA

Practice address

4865 Market St
Philadelphia, PA 19139-3508

Phone

(267) 425-9800

NPI assigned

May 2, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Kaitlin Moffett Rawluk Former name

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Children'S Hospital of Philadelphia

  • Pediatrics Physician
  • Erdenheim, PA
  • NPI 1831262732

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1932467404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4865 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393508",
            "telephone_number": "267-425-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4865 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393508",
            "telephone_number": "267-425-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDSTADTER",
        "first_name": "KAITLIN",
        "middle_name": "MOFFETT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-02",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "182235",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD454747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "RAWLUK",
            "middle_name": "MOFFETT",
            "prefix": "DR.",
            "credential": "MD MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caroline Brandon, M.D.
• John Frederick Brandsema, MD
• Erik Brandsma, M.D.
• Paul Carl Brandson, RN
• Joshua Daniel Brandstadter, M.D., PHD
• Rachel Brandstadter, M.D.
• Stefanie Sophia Brandstetter, LCSW, PSYD
• Kathryn Ashley Brandt, D.O.
• Kimberly Brandt, CRNA
• M Collette Brandt

• All providers in Philadelphia, PA
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.