Kathleen Ouellette

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

623 Newfield Ave
Stamford, CT 06905-3302

Phone

(860) 870-6385

NPI assigned

Mar 22, 2020

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 NY, CT2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleen.ouellette.1@19314.direct.athenahealth.com

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.

• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216
  Medicare reassignment NPD
• RJ Medical & Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Brooklyn, NY
  • NPI 1346632262
  Medicare reassignment
• Hartford Healthcare Medical Group Specialists LLC

  • Customized Equipment (DME)
  • Groton, CT
  • NPI 1295367068
  NPD
• 464 Bay Ridge Medical PLLC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1912568981
  NPD (past)

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

{
    "created_epoch": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587859200000",
    "number": "1194351056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 NEWFIELD AVE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069053302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 NEWFIELD AVE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069053302",
            "telephone_number": "860-870-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUELLETTE",
        "first_name": "KATHLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-22",
        "last_updated": "2020-04-26",
        "certification_date": "2020-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn Edward Ostriker, M.D.
• Mark Ostrowski, PSY.D.
• Ikenna Osuoha, PHARMD
• OT-Kids, LLC
• Roberto Otero
• Mina Owlia, MD
• Elaine Owusu-Afriyie, PHAM.D, RPH
• Jay N Oza, D.D.S.
• Nancy Ozuna
• Anthony Richard Pacchioni, R.D.

• Physician Assistant in Stamford, CT
• Providers in Stamford, 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 26, 2020; 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.