Kyle McCormack, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

002598 Issued in CT

Practice address

1 Cellini PL Ste 102
West Haven, CT 06516-1666

Phone

(203) 932-6481

Fax

(203) 932-4051

NPI assigned

Aug 15, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Merit-based Incentive Payment System (MIPS)

Final score

95.41 of 100Reported as group

Quality

83.74

Promoting interoperability

100

Improvement activities

40

Cost

72.88

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Middlesex Hospital

  • Family Nurse Practitioner
  • Middletown, CT
  • NPI 1972563138

  Medical

  Medicare reassignment NPD
• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  Medicare reassignment NPD
• Comprehensive Rehab Consultants PLLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  CT

  Medicare reassignment NPD
• Middlesex Hospital

  • Community Based Hospice Care Agency
  • Middletown, CT
  • NPI 1003873233
  NPD
• Saint Raphael Faculty Physicians

  • Internal Medicine Physician
  • New Haven, CT
  • NPI 1932138138
  NPD (past)

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1669751178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK STREET, CB-2041",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4748",
            "fax_number": "203-688-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CELLINI PL STE 102",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065161666",
            "telephone_number": "203-932-6481",
            "fax_number": "203-932-4051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York Street, CB-2041",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-4748",
            "fax_number": "203-688-4740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "KYLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-15",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "002598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kyle.mccormack@xdr.hhchealthdirect.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1 Cellini Pl Ste 102",
            "city": "West Haven",
            "state": "CT",
            "country_code": "US",
            "postal_code": "065161666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Linda L. Maxwell, NP-C
• Ratsamy Judy May, PMHNP-BC
• Preston Maynard, LCSW
• John Robert Mazzacane, RRT
• Tahjeah McClain
• Anna McCraw, RPH
• Jennifer A. McCullagh, AU.D./PH.D., CCC-A
• Patrick J McDonough, LCSW
• Laurie Anne McEvoy, RD
• Shane Michael McGloin, PT

• Medical Physician Assistant in West Haven, CT
• Providers in West Haven, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.

Verify at the official NPI Registry.