Individual provider Active NPI

Kathleen Danilczyk, PA-C

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1164658043
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00998 Issued in RI
Practice address
825 Chalkstone Ave
Providence, RI 02908-4728
Phone
(401) 459-5748
NPI assigned
Jun 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00998 RI Primary

Addresses

Primary practice location

825 Chalkstone Ave
Providence, RI 02908-4728

Mailing address

825 Chalkstone Ave
Providence, RI 02908-4728

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180205002738 RI Practitioner - Physician Assistant 3779770078 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prospect Chartercare RWMC, LLCGroup PAC ID 0547492696, 66 clinicians

Practice addresses (Care Compare)

825 Chalkstone Ave
Providence, RI 02908-4728
Phone (401) 456-2026

825 Chalkstone Ave
Providence, RI 02908-4735

Hospital & facility affiliations

  • Roger Williams Medical Center Hospital, Providence, RI, CCN 410004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Chartercare RWMC, LLC CurrentSince Oct 24, 2022 Accepting new patients
University Orthopedics, Inc. CurrentSince Jul 29, 2019 Accepting new patients
University Orthopedics, Inc. CurrentSince Jul 29, 2019 Accepting new patients
Prospect Chartercare RWMC, LLC CurrentSince Oct 24, 2022 Accepting new patients
Commonwealth Orthopaedics & Rehabilitation, PC Past Accepting new patients

Locations

1598 S County Trl
Ste 100
East Greenwich, RI 02818
Phone (401) 884-1177

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

2 Dudley St
Ste 200
Providence, RI 02905
Phone (401) 457-1504

50 Maude St
Providence, RI 02908
Phone (401) 456-2200

Organizations & group practices 6

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": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1164658043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-459-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANILCZYK",
        "first_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.