Individual provider Active NPI

Maureen Kilrain, PA-C

  • Physician Assistant
  • Brunswick, OH
National Provider Identifier
1376617167
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.000720RX Issued in OH
Practice address
3059 Grafton Rd
Brunswick, OH 44212
Phone
(440) 476-8428
NPI assigned
Nov 20, 2006
Last updated
Nov 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.000720RX OH Primary
Medical Physician Assistant 363AM0700X 50.000720RX OH

Addresses

Primary practice location

3059 Grafton Rd
Brunswick, OH 44212

Mailing address

3059 Grafton Rd
Brunswick, OH 44212-2307
Phone (440) 476-8428

Other practice location 1

70 Birch Aly
Beavercreek, OH 45440-1479
Phone (800) 892-2695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.000720RXOHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care Practice, PC Past Accepting new patients
Ny Primary Care Practice, PC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1376617167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3059 GRAFTON RD",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442122307",
            "telephone_number": "440-476-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3059 GRAFTON RD",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "44212",
            "telephone_number": "440-476-8428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Birch Aly",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454401479",
            "country_code": "US",
            "telephone_number": "800-892-2695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILRAIN",
        "first_name": "MAUREEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.000720RX",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.000720RX",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, OH

Sources for this page

Verify at the official NPI Registry.