KATELYN RAE GENOVA PA-C
NPI 1083206973
Physician Assistant - Surgical in Puyallup, WA

Active since February 11, 2021PECOS EnrolledAccepts Medicare Assignment
3801 5TH ST SE STE 110, PUYALLUP, WA 98374(253) 845-9585(253) 848-1126 Get Directions Write a Review

NPPES record last updated: October 31, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 8, 2024, Jul 28, 2022, Feb 11, 2021 (3 updates tracked since 2021).

About Katelyn Rae Genova Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATELYN RAE GENOVA PA-C (NPI 1083206973) is an individual surgical provider in Puyallup, Washington, licensed in Washington (PA61579562) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1083206973
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameKATELYN RAE GENOVACredential: PA-C
Location Address3801 5TH ST SE STE 110Puyallup, WA 98374-2106
Mailing Address3801 5th St Se Ste 110Puyallup, WA 98374-2106 · (253) 845-9585 · Fax (253) 848-1126
Fax(253) 848-1126
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateFebruary 11, 2021
Last NPPES UpdateOctober 31, 20253 updates tracked since enumeration
NPPES CertifiedOctober 31, 2025
NPI 1083206973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License Licensed in WA · PA61579562
3801 5TH ST SE STE 110, Puyallup, WA 98374

Other Identifiers 1

Medicaid2348579WA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Katelyn Rae Genova Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1355742149
PECOS Enrollment IDI20251114002471
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Orthopaedic Surgery
3801 5TH ST SE STE 110
PUYALLUP, WA 98374
Physician Assistant (Surgical)
3801 5TH ST SE STE 110
PUYALLUP, WA 98374
Physician Assistant (Surgical)
3801 5TH ST SE STE 110
PUYALLUP, WA 98374
Orthopaedic Surgery
3801 5TH ST SE STE 110
PUYALLUP, WA 98374
Physician Assistant (Surgical)
3801 5TH ST SE STE 110
PUYALLUP, WA 98374
Orthopaedic Surgery
3801 5TH ST SE STE 110
PUYALLUP, WA 98374
Physician Assistant (Surgical)
3801 5TH ST SE STE 110
PUYALLUP, WA 98374
Orthopaedic Surgery (Foot and Ankle Surgery)
3801 5TH ST SE STE 110
PUYALLUP, WA 98374

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083206973, enumerated as an "individual" on February 11, 2021.

The provider is located at 3801 5TH ST SE STE 110 PUYALLUP, WA 98374 and the phone number is (253) 845-9585.

Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.