KATELYN TAYLOR – Physician Assistant, NPI 1053982017

KATELYN TAYLOR is a healthcare provider. based in Green bay, Wisconsin. specializing in PHYSICIAN ASSISTANT. They hold a License No. 5482-23 (WI). The NPI Number for KATELYN TAYLOR is 1053982017

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
KATELYN TAYLOR
NPI
1053982017
Phone
Not provided
Address
3059 VOYAGER DR
Enumeration Date
9 July 2021
Last Update Date
20 February 2023

Doctor Profile

Medical School Name
UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Secondary Phone
9209650345
Graduation Year
2021 (5 years ago)
PAC ID
0840697298
Group Practice PAC ID
9537312665
Professional Enrollment ID
I20211005001593
Address ID
WI543118303GR3059XDRXX300
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

3,703 PHYSICIAN ASSISTANT in WI

Provider Addresses for KATELYN TAYLOR

  • 3059 VOYAGER DR

    GREEN BAY, WI 543118303

    Phone:

    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: 2021-10-05

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20210928000611IPhysician AssistantWITBD
I20211005001593IPhysician AssistantMITBD

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 growths905167$0
99213Established patient office or other outpatient visit, 20-29 minutes368271$0
17000Destruction of precancer skin growth, 1 growth288221$0
11102Biopsy of related skin growth, first growth151138$0
99203New patient office or other outpatient visit, 30-44 minutes130130$0
View full utilization report →

Insurance plans in this area (ZIP 54311)

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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: 9537312665View full group profile
NameSpecialtyState
-WI
Physician AssistantWI
Physician AssistantWI
Physician AssistantWI
Physician AssistantWI
Physician AssistantMI
Physician AssistantWI
Physician AssistantWI
Physician AssistantWI
Micrographic Dermatologic Surgery (Mds), DermatologyWI

Reviews

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Frequently asked questions

Can I cross-check KATELYN TAYLOR using NPI 1053982017?
NPI 1053982017 belongs to KATELYN TAYLOR; compare other details if you need extra assurance.
Active or inactive — what applies to KATELYN TAYLOR?
You should see KATELYN TAYLOR as active in CMS-hosted NPPES data.
What area of care is associated with KATELYN TAYLOR?
KATELYN TAYLOR's record emphasizes Physician Assistant. Clinical services aligned with this taxonomy classification.
Where in Wisconsin is KATELYN TAYLOR registered?
Use Green Bay, Wisconsin as the headline location for KATELYN TAYLOR here.
Does KATELYN TAYLOR accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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