Kathryn Cpak, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601005859 Issued in MI

Practice address

940 River Centre Dr
Port Huron, MI 48060-4463

Phone

(810) 985-4900

NPI assigned

Dec 15, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, IL, KY, TN4 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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AIIFDD

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.

• Henry Ford Health Macomb Oakland Hospital

  • Nurse Practitioner
  • Warren, MI
  • NPI 1578696092
  Medicare reassignment NPD
• Henry Ford Health System

  • Physician Assistant
  • Detroit, MI
  • NPI 1811073901

  Medical

  Medicare reassignment NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375
  Medicare reassignment NPD
• Hospitalist Physicians Medical Group of Michigan, PC

  • Emergency Medicine Physician
  • Chelsea, MI
  • NPI 1003978867
  Medicare reassignment
• Henry Ford Health Macomb-Oakland Hospital

  • Social Worker
  • Warren, MI
  • NPI 1548609761
  NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Hospitalist Physicians Medical Group of Michigan, PC

  • Emergency Medicine Physician
  • Saint Joseph, MI
  • NPI 1407618234
  NPD
• Orthopedic Associates of Port Huron PC

  • Durable Medical Equipment & Medical Supplies
  • Port Huron, MI
  • NPI 1013068188
  NPD (past)

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1992008759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 RIVER CENTRE DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604463",
            "telephone_number": "810-985-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 RIVER CENTRE DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604463",
            "telephone_number": "810-985-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CPAK",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-15",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601005859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy T Covrea, INTERN
• Stephanie Katherine Cowan
• Kimberly Ann Cowhy, R.PH
• Bryanna Danielle Cox
• Sydney Cox, FNP-BC
• Leah Crandall
• Erin Cravens, MSW, LLMSW
• Gabriel Crawford, D.O.
• Richard Crill, MD
• Melissa Croff

• Medical Physician Assistant in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.