Individual provider Active NPI

Kaitlyn Wilson, DO

  • Psychiatry Physician
  • Bethlehem, PA
National Provider Identifier
1942985783
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OT022339 Issued in PA
Practice address
257 Brodhead Rd
Bethlehem, PA 18017-8938
Phone
(484) 602-2514
NPI assigned
Jun 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OS024955 PA
Psychiatry Physician 2084P0800X OT022339 PA Primary

Addresses

Primary practice location

257 Brodhead Rd
Bethlehem, PA 18017-8938

Mailing address

257 Brodhead Rd
Bethlehem, PA 18017-8938

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250722001945 PA Practitioner - Psychiatry 1557721362 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Philadelphia College of Osteopathic Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians
Eastern Pennsylvania Physician Alliance, LLCGroup PAC ID 8325478662, 112 clinicians

Practice addresses (Care Compare)

211 N 12 St
Lehighton, PA 18235-1138
Phone (610) 865-0311

722 E Butler Pike
Ambler, PA 19002-2310
Phone (215) 643-7800

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS024955PAMDPsychiatry Physician
OT022339PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Pennsylvania Physician Alliance LLC CurrentSince Jul 28, 2025 Accepting new patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
St Luke'S Physician Group Inc CurrentSince Aug 1, 2025 Accepting new patients
St. Luke'S Physician Group, Inc. Psychiatry CurrentSince Aug 1, 2025 Accepting new patients

Locations

257 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 503-3057

2 Hospital Dr
Clarion, PA 16214
Phone (800) 253-4906

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

211 N 12th St
Lehighton, PA 18235
Phone (610) 377-1300

722 E Butler Pike
Maple Glen, PA 19002
Phone (215) 643-7800

561 Fairthorne Ave
Philadelphia, PA 19128
Phone (215) 487-4000

4641 E Roosevelt Blvd
Philadelphia, PA 19124
Phone (215) 831-4600

Organizations & group practices 4

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 6

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": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1942985783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 BRODHEAD RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180178938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 BRODHEAD RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180178938",
            "telephone_number": "484-602-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KAITLYN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS024955",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OT022339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.