KATHERINE RAE NETTLES PA-C
NPI 1215413521
Physician Assistant - Medical in Rochester, NY
About Katherine Rae Nettles Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KATHERINE RAE NETTLES PA-C (NPI 1215413521) is an individual medical provider in Rochester, New York, licensed in New York (022924) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Fairport.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
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 Rae Nettles Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
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 Nettles's NPI number?
The NPI number for Katherine Nettles is 1215413521. It was assigned to this individual provider in the NPPES registry on July 19, 2018.
Where is Katherine Nettles located?
Katherine Nettles practices at 1000 South Ave, Rochester, NY 14620. The listed phone number is (585) 473-2200.
What is Katherine Nettles's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Katherine Nettles enrolled in Medicare?
Yes. Katherine Nettles is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Katherine Nettles was last updated on April 11, 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 Rae Nettles, PA-C · NPI 1215413521
Medical physician in Rochester, New York. Individual provider, active in the CMS NPPES registry since July 19, 2018.
## Identity
- **NPI:** 1215413521 (Entity type: Individual)
- **Enumerated:** July 19, 2018
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** 022924 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 1000 SOUTH AVE, Rochester, NY 14620-2782
- **Phone:** (585) 473-2200
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** April 11, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1215413521) · Data from the CMS NPPES public registry.