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

Kathryn Mary Mansueti

Individual provider Physician Assistant · NPI 1841965175

Kathryn Mary Mansueti is a Physician Assistant in Jacksonville, Florida. Qualified in 2021, 5 years ago. Practices with Precision Dermatology and Skin Surgery PA, a 7-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
5
Licensed in
MI
In the registry since
2021
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Practice location Address checks out

1550 Riverside Ave Ste A
Jacksonville, FL 32204-4162
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.

Additional practice locations (1)

  • 1209 Park Ave, Orange Park, FL 32073-4158 — (904) 923-6647

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601010730 (MI)

Record details

NPI number1841965175
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 10, 2021
Last updated in NPPESJune 30, 2023
Certification dateJune 30, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Precision Dermatology And Skin Surgery Pa — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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