Andrea Douyard, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

000597 Issued in CT

Practice address

179 Roseland Ave
Waterbury, CT 06710

Phone

(203) 574-4747

Fax

(203) 574-2251

NPI assigned

Jul 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11240/brand/1/csg/1/fhir/r4

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.

• Staywell Health Care, Inc.

  • Family Medicine Physician
  • Waterbury, CT
  • NPI 1154342335
  Medicare reassignment NPD
• Child & Adolescent Health Care

  • Pediatrics Physician
  • Waterbury, CT
  • NPI 1497937411
  NPD (past)
• Franklin Medical Group, PC

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

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1386679355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 ROSELAND AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067101411",
            "telephone_number": "203-574-4747",
            "fax_number": "203-574-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 ROSELAND AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06710",
            "telephone_number": "203-574-4747",
            "fax_number": "203-574-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUYARD",
        "first_name": "ANDREA",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008036775",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA",
            "identifier": "1186042",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Srilatha Dosapati
• Courtney Marie Doty, LCSW
• Kayla Doucette
• Ahisha Douglas
• Robert Edward Douglass, PT, ATC
• Angelina Dowdell, BA,AS
• Matthew D Dowling, AS
• Jennifer L Downs, M.D.
• Ashley Stokes Dowty, LMSW
• Elisabeth Doyle

• Physician Assistant in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.