Michael A Kilgannon, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

025777 Issued in CT

Practice address

1703 Main St
Willimantic, CT 06226-1162

Phone

(860) 456-1252

NPI assigned

Mar 31, 2006

Last updated

Sep 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

90.42 of 100Reported as group

Quality

83.36

Promoting interoperability

100

Improvement activities

40

Cost

75.9

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Windham Medical Group

  • Internal Medicine Physician
  • Willimantic, CT
  • NPI 1013061100
  NPD

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1164483947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILASE DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "860-972-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 MAIN ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062261162",
            "telephone_number": "860-456-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILGANNON",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "025777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "25777",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethany Joy Kennedy, APRN
• Jacob Kennedy
• Tiffany Kennedy
• Divya Mangala Kestur Rajasekhar, MD
• Archna Khattar, LMFT
• Brian King, M.D.
• Elyse Kirschblum, MA CCC-A
• Steven E Knotts, CRNA
• Ajit J Kokkat, M.D.
• Jennifer Lynn Kollar, M.A.

• Internal Medicine Physician in Willimantic, CT
• Providers in Willimantic, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; 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.
• 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.