Individual provider Active NPI

Kaitlyn M Hummer, PA

  • Physician Assistant
  • Toledo, OH
National Provider Identifier
1942731963
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50005055RX Issued in OH
Practice address
2109 Hughes Dr Ste 220
Toledo, OH 43606-5121
Phone
(419) 291-5150
Fax
(419) 479-6173
NPI assigned
Mar 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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 50005055RX OH Primary

Addresses

Primary practice location

2109 Hughes Dr Ste 220
Toledo, OH 43606-5121

Mailing address

2109 Hughes Dr Ste 220
Toledo, OH 43606-5121
Phone (419) 291-5150

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khummer106419@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170711003729 OH Practitioner - Physician Assistant 1658640396 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2109 Hughes Dr
Suite 220
Toledo, OH 43606-5121
Phone (419) 291-5150

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

2901 N Reynolds Rd
Toledo, OH 43606
Phone (419) 578-7700

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50005055RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Haematology-Oncology Associates of Ohio and Michigan PC Current Accepting new patients
Promedica Central Physicians Physician Assistant CurrentSince May 1, 2017 Accepting new patients
The Toledo Hospital CurrentSince May 13, 2019 Accepting new patients
Consultants in Laboratory Medicine of Greater Toledo Current Accepting new patients
Promedica Central Physicians CurrentSince May 1, 2017 Accepting new patients
The Toledo Hospital CurrentSince May 13, 2019 Accepting new patients

Locations

2751 Bay Park Dr
Ste 303
Oregon, OH 43616
Phone (419) 690-7676

2109 Hughes Dr
Ste 220
Toledo, OH 43606
Phone (419) 291-5150

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Interoperability endpoints

  • Direct secure messaging: khummer106419@direct.promedica.org

Organizations & group practices 7

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 2

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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1942731963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 HUGHES DR STE 220",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436065121",
            "telephone_number": "419-291-5150",
            "fax_number": "419-479-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 HUGHES DR STE 220",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436065121",
            "telephone_number": "419-291-5150",
            "fax_number": "419-479-6173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMMER",
        "first_name": "KAITLYN",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50005055RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khummer106419@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "2109 Hughes Dr Ste 220",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436065121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.