Individual provider Active NPI

Katelyn Graves, PA-C

  • Physician Assistant
  • Unionville, CT
National Provider Identifier
1093187965
Registry record updated Jul 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
45 S Main St
Unionville, CT 06085-1278
Phone
(860) 470-7710
NPI assigned
Oct 30, 2015
Last updated
Jul 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

45 S Main St
Unionville, CT 06085-1278

Mailing address

25 Wall St
Unionville, CT 06085-1258
Phone (860) 428-3986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 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
I20210223000093 CT Practitioner - Physician Assistant 2365857497 Reassigns benefits to 1 organization
I20251003001393 MA Practitioner - Physician Assistant 2365857497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Medical Center LLCGroup PAC ID 0840570628, 52 clinicians

Practice addresses (Care Compare)

105 W Rd
Ellington, CT 06029-5700
Phone (860) 454-0678

136 Berlin Rd
Cromwell, CT 06416-2627
Phone (860) 378-8585

2909 Berlin Tpke
Newington, CT 06111-4115
Phone (860) 454-0678

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Medical Center LLC CurrentSince Nov 1, 2020 Accepting new patients

Locations

105 West Rd
Ellington, CT 06029
Phone (860) 454-0678

45 S Main St
Unionville, CT 06085
Phone (860) 454-0678

1505 Memorial Dr
Chicopee, MA 01020
Phone (413) 331-4336

Organizations & group practices 1

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": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689984000000",
    "number": "1093187965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WALL ST",
            "city": "UNIONVILLE",
            "state": "CT",
            "postal_code": "060851258",
            "telephone_number": "860-428-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 S MAIN ST",
            "city": "UNIONVILLE",
            "state": "CT",
            "postal_code": "060851278",
            "telephone_number": "860-470-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "KATELYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2023-07-22",
        "certification_date": "2023-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Unionville, CT

Sources for this page

Verify at the official NPI Registry.