Individual provider Active NPI

Kaitlyn Fitzpatrick, PA-C

  • Physician Assistant
  • Norwalk, CT
National Provider Identifier
1063094829
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027058 Issued in NY
Practice address
34 Maple St
Norwalk, CT 06850-3815
Phone
(203) 852-2000
NPI assigned
Apr 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5388 CT
Physician Assistant 363A00000X 027058 NY Primary

Addresses

Primary practice location

34 Maple St
Norwalk, CT 06850-3815

Mailing address

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 904-3333

Other practice location 1

1825 Eastchester Rd
Bronx, NY 10461-2301
Phone (718) 904-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211004002861 NY Practitioner - Physician Assistant 9335547454 Reassigns benefits to 2 organizations
I20220104002330 CT Practitioner - Physician Assistant 9335547454 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Reserve Rd
Danbury, CT 06810-5212

30 Hazel St
Bridgeport, CT 06604-7752

510 Thornall St
Edison, NJ 08837-2204

5555 Glenridge Connector
Suite 700
Atlanta, GA 30342-1681

Hospital & facility affiliations

  • Norwalk Hospital Hospital, Norwalk, CT, CCN 070034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5388CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Sep 21, 2021 Accepting new patients
Norwalk Hospital Association CurrentSince Dec 27, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Sep 21, 2021 Accepting new patients
Norwalk Hospital Association CurrentSince Dec 27, 2021 Accepting new patients

Locations

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

34 Maple St
Norwalk, CT 06850
Phone (203) 852-2000

111 E 210th St
Bronx, NY 10467

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

Interoperability endpoints

  • Direct secure messaging: kaitlyn.fitzpatrick@ghuc.eclinicaldirectplus.com

Organizations & group practices 6

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1063094829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-904-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MAPLE ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068503815",
            "telephone_number": "203-852-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1825 Eastchester Rd",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104612301",
            "country_code": "US",
            "telephone_number": "718-904-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "KAITLYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "5388",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.