KATHRYN DETORE OSWALT (PA-C) – Physician Assistant, NPI 1407643760

KATHRYN DETORE OSWALT (PA-C) is a healthcare provider. based in Tuscaloosa, Alabama. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 2633 (AL). The NPI Number for KATHRYN DETORE OSWALT (PA-C) is 1407643760

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
KATHRYN DETORE OSWALT (PA-C)
NPI
1407643760
Phone
(205) 759-1519
Address
4960 RICE MINE RD NE STE 40
Enumeration Date
21 April 2025
Last Update Date
17 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2057591519102
Graduation Year
2025 (1 year ago)
PAC ID
4284125709
Group Practice PAC ID
5799054904
Professional Enrollment ID
I20251112003675
Address ID
AL354063136TU4960XNEXX502
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

1,201 PHYSICIAN ASSISTANT in AL

Provider Addresses for KATHRYN DETORE OSWALT (PA-C)

  • 4960 RICE MINE RD NE STE 40

    TUSCALOOSA, AL 354063136

    Phone: (205) 759-1519

    Fax: (205) 750-8612

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-11-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251112003675IPhysician AssistantALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35406)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799054904View full group profile
NameSpecialtyState
Nurse PractitionerAL
Nurse PractitionerAL
D E R M A T O L O G YWI
D E R M A T O L O G YAL
Nurse PractitionerAL
Physician AssistantAL

Reviews

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Frequently asked questions

What is the registry number for KATHRYN DETORE OSWALT (PA-C)?
The registry entry for KATHRYN DETORE OSWALT (PA-C) shows NPI 1407643760.
Is KATHRYN DETORE OSWALT (PA-C)'s NPI status active today?
Active status means KATHRYN DETORE OSWALT (PA-C)'s NPI record is not deactivated in the public file.
What type of care does KATHRYN DETORE OSWALT (PA-C) provide?
KATHRYN DETORE OSWALT (PA-C)'s profile centers on Physician Assistant. Clinical services aligned with this taxonomy classification.
Can patients visit KATHRYN DETORE OSWALT (PA-C) in Tuscaloosa, Alabama?
For routing, start with Tuscaloosa, Alabama for KATHRYN DETORE OSWALT (PA-C), then verify phone and hours locally.
Who maintains KATHRYN DETORE OSWALT (PA-C)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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