KATHERINE KELLY FOSSETTA PHYSICIAN ASSISTANT
NPI 1013758911
Student in an Organized Health Care Education/Training Program in Portland, OR
About Katherine Kelly Fossetta Physician Assistant NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KATHERINE KELLY FOSSETTA PHYSICIAN ASSISTANT (NPI 1013758911) is an individual student in an organized health care education/training program in Portland, Oregon and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS and is a graduate of Oregon Health Sciences University School Of Medicine (2025).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Katherine Kelly Fossetta Physician Assistant is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORTLAND, OR 97201
PORTLAND, OR 97201
PORTLAND, OR 97201
PORTLAND, OR 97201
PORTLAND, OR 97201
PORTLAND, OR 97201
PORTLAND, OR 97201
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Katherine Fossetta's NPI number?
The NPI number for Katherine Fossetta is 1013758911. It was assigned to this individual provider in the NPPES registry on June 4, 2024.
Where is Katherine Fossetta located?
Katherine Fossetta practices at 2730 S Moody Ave, Portland, OR 97201. The listed phone number is (503) 494-9645.
What is Katherine Fossetta's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Katherine Fossetta enrolled in Medicare?
Yes. Katherine Fossetta is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Katherine Fossetta was last updated on June 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Katherine Kelly Fossetta, PHYSICIAN ASSISTANT · NPI 1013758911
Student in an Organized Health Care Education/Training Program provider in Portland, Oregon. Individual provider, active in the CMS NPPES registry since June 4, 2024.
## Identity
- **NPI:** 1013758911 (Entity type: Individual)
- **Enumerated:** June 4, 2024
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2730 S MOODY AVE, Portland, OR 97201-5042
- **Phone:** (503) 494-9645
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Oregon Health Sciences University School Of Medicine, class of 2025
## Record status
- **NPPES last updated:** June 4, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1013758911) · Data from the CMS NPPES public registry.