Individual provider Active NPI

Sage Ann Kenny, PA-C

  • Medical Physician Assistant
  • Norwalk, CT
National Provider Identifier
1689208571
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4753 Issued in CT
Practice address
149 Water St Apt 32
Norwalk, CT 06854-3758
Phone
(203) 545-4032
NPI assigned
Feb 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4753 CT Primary

Addresses

Primary practice location

149 Water St Apt 32
Norwalk, CT 06854-3758

Mailing address

149 Water St
Norwalk, CT 06854-3754
Phone (203) 545-4032

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200623002093 CT Practitioner - Physician Assistant 1456773365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4753CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince May 21, 2020 Accepting new patients
Yale University CurrentSince May 21, 2020 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: smiele344730@direct.ynhh.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1689208571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 WATER ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068543754",
            "telephone_number": "203-545-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 WATER ST APT 32",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068543758",
            "telephone_number": "203-545-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNY",
        "first_name": "SAGE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-28",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "4753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.