Individual provider Active NPI

Kaitlyn Ann Favalora

  • Audiologist
  • Boston, MA
National Provider Identifier
1093452302
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
133 Brookline Ave
Boston, MA 02215-3904
Phone
(617) 421-1000
NPI assigned
May 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X MA Primary

Addresses

Primary practice location

133 Brookline Ave
Boston, MA 02215-3904

Mailing address

400 Foxborough Blvd Apt 8309
Foxborough, MA 02035-3820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220920000655 MA Practitioner - Qualified Audiologist 2365827839

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

147 Milk St
Boston, MA 02109-4806

147 Milk St
Boston, MA 02109-4862

300 Apollo Dr
Chelmsford, MA 01824-3629

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4913MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Current Accepting new patients
Atrius Health, Inc. CurrentSince Sep 12, 2022 Accepting new patients
Atrius Health, Inc. CurrentSince Sep 12, 2022 Accepting new patients
Atrius Health, Inc. Past Accepting new patients

Locations

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

Interoperability endpoints

  • Direct secure messaging: kfavalora347977@direct.atrius.masshiway.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1093452302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FOXBOROUGH BLVD APT 8309",
            "city": "FOXBOROUGH",
            "state": "MA",
            "postal_code": "020353820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153904",
            "telephone_number": "617-421-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVALORA",
        "first_name": "KAITLYN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.