KATHRYN MARY MANSUETI – Physician Assistant, NPI 1841965175

KATHRYN MARY MANSUETI is a healthcare provider. based in Jacksonville, Florida. specializing in PHYSICIAN ASSISTANT. They hold a License No. 5601010730 (MI). The NPI Number for KATHRYN MARY MANSUETI is 1841965175

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
KATHRYN MARY MANSUETI
NPI
1841965175
Phone
(904) 923-6647
Address
1550 RIVERSIDE AVE STE A
Enumeration Date
10 August 2021
Last Update Date
30 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9049236647
Graduation Year
2021 (5 years ago)
PAC ID
9133517964
Group Practice PAC ID
1153547989
Professional Enrollment ID
I20230711001103
Address ID
FL320632103MA159XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for KATHRYN MARY MANSUETI

  • 1550 RIVERSIDE AVE STE A

    JACKSONVILLE, FL 322044162

    Phone: (904) 923-6647

    Fax: (904) 355-7788

    Type: Mailing

  • 1209 Park Ave

    Orange Park, FL 320734158

    Phone: (904) 923-6647

    Fax: (904) 355-7788

    Type: Location

  • 24664 RENSSELAER ST

    OAK PARK, MI 482371718

    Phone: (248) 792-1455

    Type: Mailing

  • 31815 SOUTHFIELD RD STE 22

    BEVERLY HILLS, MI 480255471

    Phone: (248) 723-5802

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $380.

Total Amount is formed as General ($380) + Research ($0) + Ownership ($0) = $380.

Last reported payment date: 2024-09-19 • Largest payer in this snapshot: PFIZER INC. ($209).

Total Amount

$380

General + Research + Ownership

Payments

16

Total payment records

General Amount

$380

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2023-07-11

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
I20230711001103IPhysician AssistantFLTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths35765$0
13121Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm121100$0
13132Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm117109$0
99213Established patient office or other outpatient visit, 20-29 minutes10396$0
17000Destruction of precancer skin growth, 1 growth8277$0
View full utilization report →

Insurance plans in this area (ZIP 32204)

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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: 1153547989View full group profile
NameSpecialtyState
Physician AssistantFL
Physician AssistantFL
Physician AssistantFL
Dermatology, PathologyFL
Physician AssistantFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

Does KATHRYN MARY MANSUETI share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KATHRYN MARY MANSUETI uses 1841965175.
Can I rely on KATHRYN MARY MANSUETI being an active provider?
As of the registry snapshot, KATHRYN MARY MANSUETI is marked active.
What is KATHRYN MARY MANSUETI's primary classification?
Physician Assistant is the headline specialty for KATHRYN MARY MANSUETI here. Clinical services aligned with this taxonomy classification.
What area does KATHRYN MARY MANSUETI serve?
KATHRYN MARY MANSUETI's listing highlights Jacksonville, Florida; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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