Shane P Kinsey, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001450 Issued in CT

Practice address

1260 Silas Deane Highway
Wethersfield, CT 06109

Phone

(860) 529-1100

NPI assigned

Dec 27, 2005

Last updated

Dec 21, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Franklin Medical Group, PC

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Waterbury, CT
  • NPI 1780686964
  NPD (past)
• Hartford Physician Services PC

  dba Hartford Medical Group

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1164404117
  NPD (past)

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198195200000",
    "number": "1225015795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1086",
            "address_2": "HARTFORD MEDICAL GROUP",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "010951086",
            "telephone_number": "508-595-0531",
            "fax_number": "508-829-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 SILAS DEANE HIGHWAY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "06109",
            "telephone_number": "860-529-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSEY",
        "first_name": "SHANE",
        "middle_name": "P",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2007-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Umair Javed Minhas Khan, MD
• Raashi Khanna, DO
• Yana Khelman, DDS
• Mackenzie Rose Kilpatrick, PA-C
• Han NA Kim, OD
• Judson D Klein, LPC
• Lindsay B Knapp, LICSW
• Thomas S Kocienda, PSY.D.
• Fafa Huberta Koudoro, MD
• Nataliya Krayzman

• Medical Physician Assistant in Wethersfield, CT
• Providers in Wethersfield, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.