Kendra Amy St. Hilaire, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2562 Issued in MA

Practice address

1093 N. Main St.
Ste 1a
Randolph, MA 02368

Phone

(781) 963-0676

Fax

(781) 963-7417

NPI assigned

Jun 20, 2008

Last updated

Sep 28, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kendra Amy Sacks Former name

Medicare fee-for-service enrollment

Enrolled in MA

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

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.

• Community Physicians Associates, Inc.

  • Family Medicine Physician
  • Milton, MA
  • NPI 1538154869
  Medicare reassignment NPD
• Medpsych Associates of New Jersey LLC

  • Mental Health Counselor
  • Ramsey, NJ
  • NPI 1649718685
  NPD (past)

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1215198460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1093 N. MAIN ST.",
            "address_2": "STE 1A",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "02368",
            "telephone_number": "781-963-0676",
            "fax_number": "781-963-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1093 N. MAIN ST.",
            "address_2": "STE 1A",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "02368",
            "telephone_number": "781-963-0676",
            "fax_number": "781-963-7417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Island Rd Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Ramsey",
            "state": "NJ",
            "postal_code": "074462822",
            "country_code": "US",
            "telephone_number": "201-995-1004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST. HILAIRE",
        "first_name": "KENDRA",
        "middle_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA2562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "SACKS",
            "middle_name": "AMY",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Southeastern Psychiatric Assoc
• Tamara Souza, DPT
• Speakteasy
• Poupette St Fleur, APRN
• Mackenzie St Louis
• Stephanie D St. Joseph
• Andrew St. Louis
• Emily St. Pierre
• Stanley ABA Consulting, LLC (Bricks-n-Blocks ABA)
• Starpoint Medical Inc.,

• Physician Assistant in Randolph, MA
• Providers in Randolph, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.