Individual provider Active NPI

Katelyn Stearns, PA-C

  • Medical Physician Assistant
  • Wasilla, AK
National Provider Identifier
1982217147
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
184340 Issued in AK
Practice address
3765 E. Blue Lupine Dr. Ste D
Wasilla, AK 99654
Phone
(907) 707-1671
NPI assigned
Aug 27, 2020
Last updated
Jul 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Medical Physician Assistant 363AM0700X 184340 AK Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

3765 E. Blue Lupine Dr. Ste D
Wasilla, AK 99654

Mailing address

3765 E. Blue Lupine Dr. Suite D
Wasilla, AK 99654
Phone (907) 707-1671

Other identifiers 1

IdentifierTypeStateIssuer
1725360MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20220201002004 AK Practitioner - Physician Assistant 0749673440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Anchorage Bariatrics, LLCGroup PAC ID 0042505018, 20 clinicians

Practice addresses (Care Compare)

3909 Arctic Blvd
Suite 101
Anchorage, AK 99503-5769
Phone (907) 770-2380

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
184340AKMDMedical 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1598486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1982217147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3765 E. BLUE LUPINE DR. SUITE D",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-707-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3765 E. BLUE LUPINE DR. STE D",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-707-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEARNS",
        "first_name": "KATELYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-27",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "184340",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1725360",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.