Individual provider Active NPI

Kristin Loucks, PA-C

  • Medical Physician Assistant
  • Norwood, MA
National Provider Identifier
1306465273
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
13 E Hoyle St
Norwood, MA 02062-3405
Phone
(781) 551-8002
NPI assigned
Apr 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

13 E Hoyle St
Norwood, MA 02062-3405

Mailing address

122A Englewood Ave Apt 2
Boston, MA 02135-7029
Phone (520) 419-2012

Other practice location 1

435 N 5th St
Phoenix, AZ 85004-2157
Phone (602) 827-2450

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201104002971 MA Practitioner - Physician Assistant 9234549163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nancy Landry PLLCGroup PAC ID 2567741887, 4 clinicians

Practice addresses (Care Compare)

1020 Broadway
Somerville, MA 02144-1819
Phone (617) 628-2160

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health Quality Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kloucks252851@direct.bilh.masshiway.net

Organizations & group practices 2

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 3

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": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1306465273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122A ENGLEWOOD AVE APT 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021357029",
            "telephone_number": "520-419-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 E HOYLE ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623405",
            "telephone_number": "781-551-8002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850042157",
            "country_code": "US",
            "telephone_number": "602-827-2450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUCKS",
        "first_name": "KRISTIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

Verify at the official NPI Registry.