Active NPI
Kaiya Mare' Sundeen
- Physician Assistant
- Portland, ME
National Provider Identifier
1659110906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA01951
- Practice address
- 716 Stevens Ave
Portland, ME 04103-2693 - Phone
- (715) 220-6250
- NPI assigned
- May 24, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | PA01951 | RI | Primary |
Addresses
Primary practice location
716 Stevens Ave
Portland, ME 04103-2693
Mailing address
716 Stevens Ave
Portland, ME 04103-2693
Other practice location 1
450 Clinton St
Woonsocket, RI 02895-3207
Phone (401) 767-4100
Other practice location 2
360 Kingstown Rd Unit 101
Narragansett, RI 02882-3258
Phone (401) 767-4100
Other practice location 3
1 River St
Wakefield, RI 02879-3214
Phone (401) 767-4100
Other practice location 4
186 Providence St
West Warwick, RI 02893-2508
Phone (401) 767-4100
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, 2026
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1885 FM 2673 Unit
Suite 146
Canyon Lake, TX 78133-4765
25 John a Cummings Way
Suite 203
Woonsocket, RI 02895-3224
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": "1716508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785456000000",
"number": "1659110906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "716 STEVENS AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "716 STEVENS AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032693",
"telephone_number": "715-220-6250"
}
],
"practiceLocations": [
{
"address_1": "450 Clinton St",
"address_purpose": "LOCATION",
"city": "Woonsocket",
"state": "RI",
"postal_code": "028953207",
"country_code": "US",
"telephone_number": "401-767-4100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "360 Kingstown Rd Unit 101",
"address_purpose": "LOCATION",
"city": "Narragansett",
"state": "RI",
"postal_code": "028823258",
"country_code": "US",
"telephone_number": "401-767-4100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 River St",
"address_purpose": "LOCATION",
"city": "Wakefield",
"state": "RI",
"postal_code": "028793214",
"country_code": "US",
"telephone_number": "401-767-4100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "186 Providence St",
"address_purpose": "LOCATION",
"city": "West Warwick",
"state": "RI",
"postal_code": "028932508",
"country_code": "US",
"telephone_number": "401-767-4100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUNDEEN",
"first_name": "KAIYA",
"middle_name": "MARE'",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-24",
"last_updated": "2026-07-31",
"certification_date": "2026-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "RI",
"license": "PA01951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.