Active NPI
Kaoutar Bouaitah
- Physician Assistant
- Worcester, MA
National Provider Identifier
1598615320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA102489
- Practice address
- 119 Belmont St
Worcester, MA 01605-2903 - Phone
- (508) 334-8515
- Fax
- (508) 334-6490
- NPI assigned
- Jan 31, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA102489 | MA | Primary |
Addresses
Primary practice location
119 Belmont St
Worcester, MA 01605-2903
Mailing address
PO Box 415348
Boston, MA 02241-5348
Phone (800) 255-8885
Other practice location 1
55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-8515
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
281 Lincoln St
Worcester, MA 01605-2192
PO Box
Boston, MA 02241
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1769817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781481600000",
"number": "1598615320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415348",
"city": "BOSTON",
"state": "MA",
"postal_code": "022415348",
"telephone_number": "800-255-8885",
"fax_number": "508-334-1977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 BELMONT ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052903",
"telephone_number": "508-334-8515",
"fax_number": "508-334-6490"
}
],
"practiceLocations": [
{
"address_1": "55 Lake Ave N",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016550002",
"country_code": "US",
"telephone_number": "508-334-8515",
"fax_number": "508-334-6490",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOUAITAH",
"first_name": "KAOUTAR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-01-31",
"last_updated": "2026-06-15",
"certification_date": "2026-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA102489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.