Individual provider Active NPI

Katelyn Marie Gdovin, PA-C

  • Physician Assistant
  • Bala Cynwyd, PA
National Provider Identifier
1982139739
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
225 E City Ave
Bala Cynwyd, PA 19004-1704
Phone
(800) 533-3669
NPI assigned
Apr 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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 Primary

Addresses

Primary practice location

225 E City Ave
Bala Cynwyd, PA 19004-1704

Mailing address

225 E City Ave
Bala Cynwyd, PA 19004-1704

Other practice location 1

1380 Easton Rd
Warrington, PA 18976-1818
Phone (215) 491-5057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20171206002010 NJ Practitioner - Physician Assistant 5294092821 Reassigns benefits to 2 organizations
I20190815001692 PA Practitioner - Physician Assistant 5294092821 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Methodist Associates in Healthcare, IncGroup PAC ID 6406755651, 387 clinicians

Practice addresses (Care Compare)

225 E City Ave
Suite 109
Bala Cynwyd, PA 19004-1724
Phone (215) 503-3838

2301 S Broad St
Philadelphia, PA 19148-3542

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince May 1, 2022 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince May 1, 2022 Accepting new patients
Methodist Associates in Healthcare, Inc. CurrentSince May 1, 2022 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

225 E City Line Ave
Ste 109
Bala Cynwyd, PA 19004
Phone (215) 503-3838

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1982139739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E CITY AVE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CITY AVE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041704",
            "telephone_number": "800-533-3669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1380 Easton Rd",
            "address_purpose": "LOCATION",
            "city": "Warrington",
            "state": "PA",
            "postal_code": "189761818",
            "country_code": "US",
            "telephone_number": "215-491-5057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GDOVIN",
        "first_name": "KATELYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

Verify at the official NPI Registry.