Katelyn McKillop, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

034634 Issued in NY

Practice address

622 W 168TH St Ste VC-260
New York, NY 10032-3720

Phone

(212) 305-5067

NPI assigned

Jul 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, PA, NY3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Haddon Emergency Physicians LLCGroup PAC ID 4082514229, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmckillop389768@direct2.lvhn.org
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Haddon Emergency Physicians LLC

  • Emergency Medicine Physician
  • Camden, NJ
  • NPI 1558312785
  Medicare reassignment Care Compare group
• Emergency Care Services of New York, P.C.

  • Emergency Medicine Physician
  • Syracuse, NY
  • NPI 1639236656
  Medicare reassignment NPD
• St. Luke'S Hosptial

  • Urgent Care Clinic/Center
  • Wind Gap, PA
  • NPI 1376965731
  Medicare reassignment NPD
• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347
  Medicare reassignment
• Lehigh Valley Physician Group

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment
• Main Line Emergency Med Associates LLC

  • Emergency Medicine Physician
  • Paoli, PA
  • NPI 1316919368
  Medicare reassignment
• St. Luke'S Hospital

  • Urgent Care Clinic/Center
  • Bethlehem, PA
  • NPI 1740232719
  Medicare reassignment
• St. Luke'S Hospital Monroe Campus

  • Occupational Medicine Physician
  • Stroudsburg, PA
  • NPI 1609311257
  Medicare reassignment
• St. Luke'S Quakertown Hospital

  • Anatomic Pathology & Clinical Pathology Physician
  • Quakertown, PA
  • NPI 1225052616
  Medicare reassignment
• St. Luke'S Warren Physician Group, PC

  • Hematology & Oncology Physician
  • Phillipsburg, NJ
  • NPI 1467725184
  Medicare reassignment
• The Carbon-Schuylkill Community Hospital, Inc.

  • Emergency Medicine Physician
  • Coaldale, PA
  • NPI 1194891010
  Medicare reassignment
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488

  Physician Assistant

  NPD

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

• Virtua Our Lady of Lourdes Hospital Inc

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1235134024
  Care Compare affiliation

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1932718061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST STE VC-260",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST STE VC-260",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKILLOP",
        "first_name": "KATELYN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-24",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061676",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA061676",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034634",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "0A005296",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Patrick McKiernan, FNP-BC, OCN
• James M McKiernan, MD
• Janet T. McKiernan, RN, NP-C
• Maureen McKiernan, MD
• Constance Isabella McKillion
• Angela McKinlay, FNP-C
• Carina Ann McKinley
• George F McKinley, M.D.
• Mark McKinley, PSY.D.
• Shakirra McKinley

• Physician Assistant in New York, NY
• Providers in New York, 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 Feb 5, 2026; 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.