Donald Kagan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

000919 Issued in CT

Practice address

2 Broadway Ste 2
North Haven, CT 06473

Phone

(203) 234-6500

Fax

(203) 234-6503

NPI assigned

Sep 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Credentials

Physician Assistant

Practice roles

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.

• Broadway Medical Group, LLC

  • Internal Medicine Physician
  • North Haven, CT
  • NPI 1649466061
  Medicare reassignment
• Feel Well Health Center of Southington, P.C.

  • Internal Medicine Physician
  • Plantsville, CT
  • NPI 1548305584
  Medicare reassignment
• Family Practice & Internal Medicine of Spring Gren LLC

  • Internal Medicine Physician
  • Hamdeh, CT
  • NPI 1255371571
  NPD (past)
• Nuvance Health Medical Practice CT, Inc.

  • Internal Medicine Physician
  • Danbury, CT
  • NPI 1407898117
  NPD (past)
• The Charlotte Hungerford Hospital

  • General Acute Care Hospital
  • Torrington, CT
  • NPI 1629075734
  NPD (past)
• Vicki Sara Blumberg, MD

  • Internal Medicine Physician
  • Danbury, CT
  • NPI 1841220126
  NPD (past)

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1164418257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BROADWAY STE 2",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732370",
            "telephone_number": "203-234-6500",
            "fax_number": "203-234-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BROADWAY STE 2",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "06473",
            "telephone_number": "203-234-6500",
            "fax_number": "203-234-6503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52 Washington Ave",
            "address_2": "Suite 4",
            "address_purpose": "LOCATION",
            "city": "North Haven",
            "state": "CT",
            "postal_code": "064731724",
            "country_code": "US",
            "telephone_number": "203-672-2800",
            "fax_number": "203-672-2801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAGAN",
        "first_name": "DONALD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000919",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "000919",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROADMEDICARE",
            "identifier": "P00441644",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "091900",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "290000919CT06",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Noura Jeblawi
• Matthew Jones, PA
• Michaela Seward Jones, NP
• Joseph S. Elman, M.D., P.C.
• Taylor Joyce
• Nomiki Kanakis, BCBA-LBA
• Justin Otto Kastenhuber, LMSW
• Kathryn L. McGibbon, LCSW, LLC
• Meredith Wallace Kazer, PHD, APRN-BC
• Daniel Jones Keady, LPC

• Physician Assistant in North Haven, CT
• Providers in North Haven, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.