Individual provider Active NPI

Katelyn Lashell Quehl, PA-C

  • Medical Physician Assistant
  • Oswego, NY
National Provider Identifier
1932987732
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
105 County Route 45a Ste 100
Oswego, NY 13126-6665
Phone
(315) 342-6771
Fax
(315) 342-2842
NPI assigned
Sep 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

105 County Route 45a Ste 100
Oswego, NY 13126-6665

Mailing address

3374 Maple Ave
Pulaski, NY 13142-2614
Phone (315) 530-7479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20231108000445 NY Practitioner - Physician Assistant 2961859236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of Ny Upstate Medical University, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Care PCGroup PAC ID 9032367453, 74 clinicians

Practice addresses (Care Compare)

110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5511

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1932987732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3374 MAPLE AVE",
            "city": "PULASKI",
            "state": "NY",
            "postal_code": "131422614",
            "telephone_number": "315-530-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 COUNTY ROUTE 45A STE 100",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131266665",
            "telephone_number": "315-342-6771",
            "fax_number": "315-342-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEHL",
        "first_name": "KATELYN",
        "middle_name": "LASHELL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-21",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.