Individual provider Active NPI

Kathryn Anne McVicar, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • New Haven, CT
National Provider Identifier
1023158904
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
MD484991 Issued in PA
Practice address
330 Cedar St # Lmp3088
Yale Medical Pediatric Neurology
New Haven, CT 06510-3218
Phone
(203) 785-5708
NPI assigned
Feb 8, 2007
Last updated
May 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 77552 CT
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X MD484991 PA Primary

Addresses

Primary practice location

330 Cedar St # Lmp3088
Yale Medical Pediatric Neurology
New Haven, CT 06510-3218

Mailing address

1010 West 8TH Avenue
Ste 1
King of Prussia, PA 19406-1349
Phone (856) 346-0005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161103002037 CT Practitioner - Pediatric MedicinePractitioner - Neurology 3476740101 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
77552CTMDNeurology with Special Qualifications in Child Neurology Physician
MD484991PAMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Oct 11, 2016 Accepting new patients
Yale University CurrentSince Oct 11, 2016 Accepting new patients
Montefiore Medical Center Neurology With Special Qualifications in Child Neurology Past Accepting new patients
Ut Lebonheur Pediatric Specialists, Inc. Neurology With Special Qualifications in Child Neurology Past Accepting new patients
CNNH Therapy LLC PastSince May 26, 2024 Accepting new patients

Locations

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1023158904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 WEST 8TH AVENUE",
            "address_2": "STE 1",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061349",
            "telephone_number": "856-346-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 CEDAR ST # LMP3088",
            "address_2": "YALE MEDICAL PEDIATRIC NEUROLOGY",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103218",
            "telephone_number": "203-785-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCVICAR",
        "first_name": "KATHRYN",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CT",
            "license": "77552",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "PA",
            "license": "MD484991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.