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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KATHARINE KICAK
NPI 1780511105
Physician Assistant - Surgical in Greenville, SC

Active since May 07, 2026PECOS Enrolled
890 W FARIS RD STE 550, GREENVILLE, SC 29605(864) 455-6800(864) 455-6825 Get Directions Write a Review

NPPES record last updated: September 22, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 22, 2026, May 7, 2026 (2 updates tracked since 2026).

About Katharine Kicak NPPES

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

KATHARINE KICAK (NPI 1780511105) is an individual surgical provider in Greenville, South Carolina, licensed in South Carolina (6533) and active in the NPI registry since May 2026. She is enrolled in Medicare PECOS and maintains a secondary practice location in Piscataway.

NPPES Registry Identity

NPI1780511105
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameKATHARINE KICAK
Location Address890 W FARIS RD STE 550Greenville, SC 29605-4286
Mailing Address300 E Mcbee Ave Fl 4Greenville, SC 29601-2842
Phone(864) 455-6800
Fax(864) 455-6825
Sole ProprietorNo
Enumeration DateMay 7, 2026
Last NPPES UpdateSeptember 22, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 22, 2026
✔ NPI 1780511105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in SC · 6533
Also ListedPhysician AssistantTaxonomy 363A00000X
890 W FARIS RD STE 550, Greenville, SC 29605
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Secondary Practice Location 1

Location 1675 Hoes Ln WPiscataway, NJ 08854-8021 · Phone (732) 445-4636

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katharine Kicak 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.

Other Providers at the Same Location NPPES 10

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

SUMMER TOMS PA-C
Physician Assistant (Surgical)
890 W FARIS RD STE 550
GREENVILLE, SC 29605
Greenville County (864) 455-6800
ERNEST W STOKES III PA
Physician Assistant (Surgical)
890 W FARIS RD STE 550
GREENVILLE, SC 29605
Greenville County (864) 455-6800
SACHIN SHAH MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
890 W FARIS RD STE 550
GREENVILLE, SC 29605
Greenville County (864) 455-6800
JENNIFER M. HERBERT FNP-BC
Nurse Practitioner (Family)
890 W FARIS RD STE 550
GREENVILLE, SC 29605
Greenville County (864) 455-6800
GARY FRANKLIN SZETO DNP, APRN, NP-C
Nurse Practitioner (Adult Health)
890 W FARIS RD STE 550
GREENVILLE, SC 29605
Greenville County (864) 455-6800
PREMNAUTH RABINDRANAUTH MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
890 W FARIS RD STE 550
GREENVILLE, SC 29605
Greenville County (864) 455-6800
JORDAN OWEN GOODWIN
Physician Assistant
890 W FARIS RD STE 550
GREENVILLE, SC 29605
Greenville County (864) 455-6800
JOHN S KABAS M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
890 W FARIS RD STE 550
GREENVILLE, SC 29605
Greenville County (864) 455-6800

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 Katharine Kicak's NPI number?

The NPI number for Katharine Kicak is 1780511105. It was assigned to this individual provider in the NPPES registry on May 7, 2026.

Where is Katharine Kicak located?

Katharine Kicak practices at 890 W Faris Rd Ste 550, Greenville, SC 29605. The listed phone number is (864) 455-6800.

What is Katharine Kicak's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Katharine Kicak enrolled in Medicare?

Yes. Katharine Kicak is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Katharine Kicak was last updated on September 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days 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.