Individual provider Active NPI

Kaitlyn A Lyver, PA-C

  • Physician Assistant
  • Shelton, CT
National Provider Identifier
1194274746
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7069 Issued in CT
Practice address
110 Commerce Dr
Shelton, CT 06484-6244
Phone
(203) 929-7331
Fax
(203) 925-0330
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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 7069 CT Primary

Addresses

Primary practice location

110 Commerce Dr
Shelton, CT 06484-6244

Mailing address

67 Maple Ave
Derby, CT 06418-1328
Phone (203) 929-7331

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250424002012 CT Practitioner - Physician Assistant 8325564123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Griffin Faculty Physicians IncGroup PAC ID 7618871997, 125 clinicians

Practice addresses (Care Compare)

111 Wakelee Ave
Ansonia, CT 06401-1151
Phone (203) 308-2781

130 Division St
Derby, CT 06418-1326
Phone (203) 732-1352

144 Oxford Rd
Suite 1a
Oxford, CT 06478-1982
Phone (203) 888-5527

224 Leavenworth Rd
Shelton, CT 06484-1881
Phone (203) 926-1206

330 Bridgeport Ave
Shelton, CT 06484-3861
Phone (203) 929-7331

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7069CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine & Pediatrics LLC Past Accepting new patients
The Griffin Hospital PastSince Apr 20, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kaitlyn.lyver.1@1323.direct.athenahealth.com

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": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1194274746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MAPLE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181328",
            "telephone_number": "203-929-7331",
            "fax_number": "203-925-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 COMMERCE DR",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846244",
            "telephone_number": "203-929-7331",
            "fax_number": "203-925-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYVER",
        "first_name": "KAITLYN",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "7069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

Verify at the official NPI Registry.