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KATHRYN AGNES FAHLSTROM PA-C
NPI 1487936886
Physician Assistant in Ann Arbor, MI

Active since September 13, 2011PECOS Enrolled
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109(734) 936-4000 Get Directions Write a Review

NPPES record last updated: October 4, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kathryn Agnes Fahlstrom Pa-c NPPES

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

KATHRYN AGNES FAHLSTROM PA-C (NPI 1487936886) is an individual physician assistant in Ann Arbor, Michigan, licensed in Michigan (5601006020) and active in the NPI registry since September 2011. She is enrolled in Medicare PECOS and maintains a secondary practice location in Ann Arbor.

NPPES Registry Identity

NPI1487936886
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKATHRYN AGNES FAHLSTROMCredential: PA-C
Location Address1500 E MEDICAL CENTER DRAnn Arbor, MI 48109-5000
Mailing Address3621 S State StAnn Arbor, MI 48108-1633 · (734) 647-5299
Phone(734) 936-4000
Sole ProprietorNo
Enumeration DateSeptember 13, 2011
Last NPPES UpdateOctober 4, 2022
NPPES CertifiedOctober 4, 2022
✔ NPI 1487936886 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 MI · 5601006020
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.
1500 E MEDICAL CENTER DR, Ann Arbor, MI 48109
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Other Names 1

Former Name (1)Kathryn Agnes Mooradian

Secondary Practice Location 1

Location 11979 Huron PkwyAnn Arbor, MI 48104-4141 · Phone (734) 344-4567 · Fax (734) 669-1104

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathryn Agnes Fahlstrom Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48109 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
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.

LOKMAN SUNG MD
Pathology (Forensic Pathology)
1500 E MEDICAL CENTER DR, 2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY
ANN ARBOR, MI 48109
Washtenaw County (800) 862-7284
SAMEER DEV SAINI M.D.
Internal Medicine (Gastroenterology)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Washtenaw County (734) 936-4000
KYLE DAVID PERRY MD
Pathology (Cytopathology)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Washtenaw County (734) 936-4000
DR. DAVID ALEXANDER STEWART M.D.
Pediatrics
1500 E MEDICAL CENTER DR, 12TH FLOOR C.S. MOTT CHILDREN'S HOSPITAL ROOM 525
ANN ARBOR, MI 48109
Washtenaw County (734) 763-5302
DR. MICHAEL EDMUND WATSON MD
Pediatrics (Pediatric Infectious Diseases)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Washtenaw County (734) 936-4000
CARRIE KRAEGER PORTER PA-C
Physician Assistant
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Washtenaw County (734) 936-6666
DENISE LYNN BERRY CRNA
Nurse Anesthetist, Certified Registered
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Washtenaw County (734) 936-4000
KETTI SOPHIA PETERSEN MD
Family Medicine (Hospice and Palliative Medicine)
1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109
Washtenaw County (734) 936-4000

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 Kathryn Fahlstrom's NPI number?

The NPI number for Kathryn Fahlstrom is 1487936886. It was assigned to this individual provider in the NPPES registry on September 13, 2011. The provider is also known as Kathryn Agnes Mooradian.

Where is Kathryn Fahlstrom located?

Kathryn Fahlstrom practices at 1500 E Medical Center Dr, Ann Arbor, MI 48109. The listed phone number is (734) 936-4000.

What is Kathryn Fahlstrom's specialty?

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

Is Kathryn Fahlstrom enrolled in Medicare?

Yes. Kathryn Fahlstrom is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kathryn Fahlstrom was last updated on October 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.