Active NPI
Katelyn Mastrogiacomo, PA-C
- Surgical Physician Assistant
- Bridgeport, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 4397
- Practice address
- 2800 Main St
Bridgeport, CT 06606-4201 - Phone
- (203) 576-6000
- NPI assigned
- Oct 29, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 4397 | CT | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2800 Main St
Bridgeport, CT 06606-4201
Mailing address
635 Ashley CT
Cheshire, CT 06410-3246
Phone (203) 980-1836
Other names 1
- Katelyn Morico
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579
2800 Main St
Bridgeport, CT 06606-4201
Hospital & facility affiliations
- St Vincent'S Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.42 of 100
- Quality
- 83.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.9
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group Specialists, PLLC | Surgical | Current | Accepting new patients |
| Hartford Healthcare Medical Group Specialists LLC | Current | Accepting new patients |
Locations
2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366
2720 Main St
Ste 1
Bridgeport, CT 06606
1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579
Interoperability endpoints
- katelyn.morico@xdr.hhchealthdirect.org
Organizations & group practices 3
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.
-
- Surgery Physician
- Hartford, CT
- NPI 1023584216
Surgical
-
- General Practice Physician
- Torrington, CT
- NPI 1043544489
-
- Customized Equipment (DME)
- Groton, CT
- NPI 1295367068
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bridgeport, CT
- NPI 1942224696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1346717352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "635 ASHLEY CT",
"city": "CHESHIRE",
"state": "CT",
"postal_code": "064103246",
"telephone_number": "203-980-1836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066064201",
"telephone_number": "203-576-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTROGIACOMO",
"first_name": "KATELYN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-29",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CT",
"license": "4397",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATELYN",
"last_name": "MORICO",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.