Katherine Dezutter, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA7967 Issued in MA

Practice address

819 Worcester St Ste 1
Springfield, MA 01151-1056

Phone

(413) 304-2501

Fax

(413) 789-0290

NPI assigned

Aug 18, 2017

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

State licenses

Practice roles

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.

• CH Specialty Services Ma PC

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1902510720
  Medicare reassignment
• Curana Health of Massachusetts LLC

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1154779445
  Medicare reassignment
• The New England Center for Children, Inc.

  • Community/Behavioral Health Agency
  • Southborough, MA
  • NPI 1629193776
  NPD (past)

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1578089769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 WORCESTER ST STE 1",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011511056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 WORCESTER ST STE 1",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011511056",
            "telephone_number": "413-304-2501",
            "fax_number": "413-789-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZUTTER",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-18",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA7967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nina Devine
• Neil C Devoe, DO
• Devamarie Devos-Moore
• John Day Deweese, M.D.
• Jane Dexter, M.A.,CCC-SLP
• DG Physical Therapy, P.C.
• Armaan Dhaliwal
• Khushwant Dhaliwal
• Vishah Dhamee, DDS
• Pinky Dhariwal, DDS

• Medical Physician Assistant in Springfield, MA
• Providers in Springfield, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.