Kathryn Fallavollita, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01569 Issued in RI

Practice address

375 Wampanoag TRL
Riverside, RI 02915-2232

Phone

(401) 649-4070

Fax

(401) 649-4071

NPI assigned

Jul 21, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Interoperability endpoints

• Direct secure messaging: kathryn.fallavollita.1@734.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Steward Medical Group, Inc

  • Internal Medicine Physician
  • Dartmouth, MA
  • NPI 1821349317
  Medicare reassignment NPD
• Family Medicine Associates of South Attleboro, P.C.

  • Family Medicine Physician
  • South Attleboro, MA
  • NPI 1750309431
  Medicare reassignment
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1275918286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 3010, PO BOX 986524",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986524",
            "telephone_number": "401-443-4992",
            "fax_number": "401-537-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029152232",
            "telephone_number": "401-649-4070",
            "fax_number": "401-649-4071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 Faunce Corner Rd",
            "address_purpose": "LOCATION",
            "city": "Dartmouth",
            "state": "MA",
            "postal_code": "027471242",
            "country_code": "US",
            "telephone_number": "508-996-3991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FALLAVOLLITA",
        "first_name": "KATHRYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3383",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA5430",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth English, DPT
• Equanimity LLC
• Christianne Esposito-Smythers, PHD
• Lisa Faille, PH.D.
• Carol Falcone, MSN, APPHRN
• Family Doctors of East Providence, Inc.
• Feeling Full Nutrition
• Altoniece Lewis Fernandes, LCSW
• Amanda J. Fernandes, MD
• Sarah Jane Fessler, MD

• Physician Assistant in Riverside, RI
• Providers in Riverside, RI by specialty
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.