KATHRYN CPAK PA-C
NPI 1992008759
Physician Assistant - Medical in Port Huron, MI

Q: What is the provider's specialty?

The provider's specialty is Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

Active since December 15, 2010PECOS Enrolled

940 RIVER CENTRE DR, PORT HURON, MI 48060(810) 985-4900 Get Directions Write a Review

NPPES record last updated: March 4, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Kathryn Cpak Pa-c NPPES

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

KATHRYN CPAK PA-C (NPI 1992008759) is an individual medical provider in Port Huron, Michigan, licensed in Michigan (5601005859) and active in the NPI registry since December 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1992008759

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameKATHRYN CPAKCredential: PA-C

Location Address940 RIVER CENTRE DRPort Huron, MI 48060-4463

Mailing Address940 River Centre DrPort Huron, MI 48060-4463 · (810) 985-4900

Phone(810) 985-4900

Sole ProprietorNo

Enumeration DateDecember 15, 2010

Last NPPES UpdateMarch 4, 2013

✔ NPI 1992008759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in MI · 5601005859

940 RIVER CENTRE DR, Port Huron, MI 48060

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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 Cpak 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.