Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kaitlyn Michelle Fagan, PA

Individual provider Physician Assistant · NPI 1043900590

Kaitlyn Michelle Fagan, PA is a Physician Assistant in Jacksonville, Florida. Qualified in 2023, 3 years ago. Practices with Precision Dermatology and Skin Surgery PA, a 7-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2023
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1550 Riverside Ave
Jacksonville, FL 32204-4161
Phone: (904) 923-6647
Fax: (904) 355-7788
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1043900590
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 9, 2023
Last updated in NPPESFebruary 13, 2025
Certification dateFebruary 13, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Precision Dermatology And Skin Surgery Pa — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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