Active NPI
Kevin C Traina, PA
- Physician Assistant
- Southbridge, MA
National Provider Identifier
1598743569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 412
- Practice address
- 94 South St
Southbridge, MA 01550-4000 - Phone
- (508) 764-2772
- Fax
- (508) 764-2833
- NPI assigned
- Jan 9, 2006
- Last updated
- Mar 24, 2015
- Sex
- Male
- 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 | 412 | MA | Primary |
Addresses
Primary practice location
94 South St
Southbridge, MA 01550-4000
Mailing address
PO Box 40
Southbridge, MA 01550-0040
Phone (508) 909-7799
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8300940 | Other | EVERCARE | |
| 042472266 | Other | THREE RIVERS | |
| AP0183 | Other | MEDICARE B | |
| 64772 | Other | FALLON COMMUNITY HEALTH | |
| 042472266 | Other | TRICARE CHAMPUS | |
| 970022720 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 412 | MA | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427155200000",
"number": "1598743569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 40",
"city": "SOUTHBRIDGE",
"state": "MA",
"postal_code": "015500040",
"telephone_number": "508-909-7799",
"fax_number": "508-764-2432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94 SOUTH ST",
"city": "SOUTHBRIDGE",
"state": "MA",
"postal_code": "015504000",
"telephone_number": "508-764-2772",
"fax_number": "508-764-2833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAINA",
"first_name": "KEVIN",
"middle_name": "C",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-09",
"last_updated": "2015-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "412",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "8300940",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THREE RIVERS",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE B",
"identifier": "AP0183",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON COMMUNITY HEALTH",
"identifier": "64772",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE CHAMPUS",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "970022720",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Southbridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.