Kiley Doyle Michaels

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5337 Issued in CT

Practice address

3801 E Main St
Waterbury, CT 06705-3815

Phone

(203) 709-4030

Fax

(203) 709-5289

NPI assigned

Jan 12, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Trinity Health of New England Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Bloomfield, CT
  • NPI 1447867452
  Medicare reassignment
• Danbury Hospital

  • General Acute Care Hospital
  • New Milford, CT
  • NPI 1619938016
  NPD

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1114516341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067053815",
            "telephone_number": "203-709-4030",
            "fax_number": "203-709-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067053815",
            "telephone_number": "203-709-4030",
            "fax_number": "203-709-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELS",
        "first_name": "KILEY",
        "middle_name": "DOYLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2022-04-06",
        "certification_date": "2021-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "5337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mgda
• Sandra T Micalizzi, APRN
• Michael a Mandino Jr D.D.S Dr Louis a Juliano D.D.S. LLC
• Michael M. Greenwald DDS PC
• Michael Z Fein DPM PC
• Jenna M Michaud
• Middle CT Emergency Physicians LLC
• Tanya Miko, MSW
• Jaclyn Milano, PA-C
• Jesse D Miller-Khodik, LPC

• Physician Assistant in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.