Individual provider Active NPI

Kavitha Kayathi, M.D.

  • Family Medicine Physician
  • Winchendon, MA
National Provider Identifier
1114160736
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
251126 Issued in MA
Practice address
55 Hospital Dr
Winchendon, MA 01475-1820
Phone
(978) 297-2331
Fax
(978) 297-4173
NPI assigned
Apr 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 251126 MA Primary

Addresses

Primary practice location

55 Hospital Dr
Winchendon, MA 01475-1820

Mailing address

55 Hospital Dr
Winchendon, MA 01475-1820
Phone (978) 297-2331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20200423000674 SC Practitioner - Family Practice 9133370158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians

Practice addresses (Care Compare)

1000 Wellness Way
Fort Mill, SC 29715-7315
Phone (803) 329-1234

222 Herlong Ave S
Rock Hill, SC 29732-1158
Phone (803) 329-1234

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
251126MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Hospitalist Services PC Family Medicine CurrentSince May 1, 2020 Accepting new patients
Amisub of South Carolina, Inc. Past Accepting new patients
David C. Flemming MD PLLC Past Accepting new patients

Locations

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

Organizations & group practices 3

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 1

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": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1114160736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HOSPITAL DR",
            "city": "WINCHENDON",
            "state": "MA",
            "postal_code": "014751820",
            "telephone_number": "978-297-2331",
            "fax_number": "978-297-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HOSPITAL DR",
            "city": "WINCHENDON",
            "state": "MA",
            "postal_code": "014751820",
            "telephone_number": "978-297-2331",
            "fax_number": "978-297-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYATHI",
        "first_name": "KAVITHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-13",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "251126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchendon, MA

Sources for this page

Verify at the official NPI Registry.