KATHRYN E DOREMUS (NPI# 1417288325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417288325 |
| Entity Type | Individual |
| Full Name | KATHRYN E DOREMUS |
| Credential | PA-C |
| Practice Address |
1571 Washington St Ste 201 Watertown NY 13601 |
| Mailing Address |
1571 Washington St Ste 201 Watertown NY 13601-9304 |
| Practice Telephone | 3157821650 |
| Mailing Telephone | 3157821650 |
| Enumeration Date | 2010-01-18 |
| Last Update Date | 2018-05-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
020329 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
OA002432 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
MA54269 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 05032086 | 05 | |
| CAQH | 12078131 | 01 |
| Street Address |
1571 WASHINGTON ST STE 201 |
| City | WATERTOWN |
| State | NY |
| Zip Code | 13601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346725157 | Scott William Niel Mollison | Orthopaedic Surgery | 1571 Washington St Ste 201, Watertown, NY 13601-9304 | 2018-09-27 |
| 1679884779 | Natalie Nielsen | Orthopaedic Surgery | 1571 Washington St Ste 201, Watertown, NY 13601-9304 | 2010-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414156 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 122 Court Street, Empsall Bldg, Room 212, Watertown, NY 13601 | 2020-07-13 |
| 1083231377 | Katherine Anne Cahill | Counselor | 22679 Duffy Road, Watertown, NY 13601 | 2020-07-02 |
| 1851855431 | Hanna Kearney | Physical Therapist | 20053 Summit View Blvd Ste 2, Watertown, NY 13601 | 2019-01-28 |
| 1578039905 | North Country Counseling Services LLC | Counselor | 210 Court St. Suite 4, Watertown, NY 13601 | 2018-10-24 |
| 1073004388 | Megan Anna O'brien | Counselor | 221 S Rutland Street, Watertown, NY 13601 | 2018-05-22 |
| 1558860536 | Kimberly Lynne Amelio | Specialist | 24850 Hinds Rd, Watertown, NY 13601 | 2018-02-06 |
| 1952840050 | Alberto Gonzalez | Social Worker | 211 Jb Wise Plaza, Watertown, NY 13601 | 2017-02-22 |
| 1073967386 | Amanda Pisarski | Licensed Practical Nurse | 26713 Nys Rte 12, Watertown, NY 13601 | 2016-04-22 |
| 1396137709 | Daniel Ernest Morgan | Neuromusculoskeletal Medicine & OMM | 21101 Ny-12f, Building 2, Suite 7, Watertown, NY 13601 | 2015-02-21 |
| 1568868131 | Megan E. Zamora | Dental Hygienist | 14652-b Cedar Way, Watertown, NY 13601 | 2014-11-10 |
| Find all providers in zip 13601 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275529554 | Melissa A Charlebois | Physician Assistant | 826 Washington St, Suite 204, Watertown, NY 13601-4063 | 2005-09-22 |
| 1154327161 | Milagros C Smith | Physician Assistant | 727 Washington St, Watertown, NY 13601-4031 | 2005-06-23 |
| 1811509276 | Lisa Dwello | Physician Assistant | 160 Stone St, Watertown, NY 13601-3261 | 2020-08-18 |
| 1205469186 | Robert James Pickeral Jr. | Physician Assistant | 53-59 Public Sq Ste 301, Watertown, NY 13601-2674 | 2020-02-19 |
| 1730644949 | Sarabrooke Mowery | Physician Assistant | 830 Washington St, Watertown, NY 13601-4034 | 2019-02-01 |
| 1710395058 | Promporn June Suwanabol | Physician Assistant | 123 Hospital Dr, Suite 2009, Watertown, WI 53098-3331 | 2014-07-30 |
| 1881018588 | Katherine S. Johnson | Physician Assistant | 1571 Washington St, Suite 104, Watertown, NY 13601-9304 | 2014-02-15 |
| 1356673883 | Justin James Martinson | Physician Assistant | 401 9th Ave Nw, Watertown, SD 57201-1548 | 2010-02-09 |
| 1063691491 | Maria Noelle Alicea | Physician Assistant | 1575 Washington St, Watertown, NY 13601-9371 | 2007-11-01 |
| 1467534396 | Thomas U. Moody Sr. | Physician Assistant | 21017 State Route 12f, Watertown, NY 13601-1078 | 2006-10-19 |
| Find all providers in WATERTOWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.