KATHARYN MARY
NPI 1194512061
Physician Assistant in Hattiesburg, MS

Q: What is Katharyn Mary's NPI number?

The NPI number for Katharyn Mary is 1194512061. It was assigned to this individual provider in the NPPES registry on April 23, 2025.

Q: What is Katharyn Mary's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Katharyn Mary was last updated on July 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.

Active since April 23, 2025PECOS EnrolledAccepts Medicare Assignment

415 S 28TH AVE, HATTIESBURG, MS 39401(601) 268-5650(601) 579-5212 Get Directions Write a Review

NPPES record last updated: July 29, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Katharyn Mary NPPES

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

KATHARYN MARY (NPI 1194512061) is an individual physician assistant in Hattiesburg, Mississippi, licensed in Mississippi (PA00912) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS, is affiliated with Forrest General Hospital, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1194512061

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKATHARYN MARY

Location Address415 S 28TH AVEHattiesburg, MS 39401-7246

Mailing Address415 S 28th AveHattiesburg, MS 39401-7246 · (601) 264-6000 · Fax (601) 579-5212

Phone(601) 268-5650

Fax(601) 579-5212

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateApril 23, 2025

Last NPPES UpdateJuly 29, 2025

NPPES CertifiedJuly 29, 2025

✔ NPI 1194512061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MS · PA00912

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

415 S 28TH AVE, Hattiesburg, MS 39401

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, UnitedHealthcare.Insurance ›

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

Katharyn Mary 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 ID7517475452

PECOS Enrollment IDI20250801003846

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Forrest General Hospital

Acute Care Hospitals · Hattiesburg, MS

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number250078

Location6051 Us Highway 49 SouthHattiesburg, MS 39404 · Forrest County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$64.96 typical visit price

range $16.15 – $129.61

Typical copayment $16.24 (range $4.03 – $32.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

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