Individual provider Active NPI

Krystal Coutcher, PA-C

  • Medical Physician Assistant
  • Warwick, RI
National Provider Identifier
1700338407
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA01257 Issued in RI
Practice address
535 Centerville Rd
Warwick, RI 02886-4486
Phone
(800) 659-5411
NPI assigned
Oct 28, 2016
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA01257 RI Primary
Medical Physician Assistant 363AM0700X 23.003718 CT

Addresses

Primary practice location

535 Centerville Rd
Warwick, RI 02886-4486

Mailing address

489 Comstock Pkwy
Cranston, RI 02921-2345
Phone (203) 800-5567

Other practice location 1

134 Grandview Ave
210
Waterbury, CT 06708-2507
Phone (203) 754-2535

Other practice location 2

2 Adams Pl Ste 305
Quincy, MA 02169-7456
Phone (617) 302-4194

Other practice location 3

6 Blackstone Valley Pl Ste 502
Lincoln, RI 02865-1102
Phone (401) 334-6262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20201217002708 RI Practitioner - Physician Assistant 1557644507 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ivy Medical Group PLLCGroup PAC ID 4981097797, 120 clinicians
Healthadvisors LLCGroup PAC ID 8325486244, 13 clinicians

Practice addresses (Care Compare)

100 Chambers St
Cumberland, RI 02864-7724
Phone (212) 734-6621

6 Blackstone Valley PL
Suite 502
Lincoln, RI 02865-1102
Phone (401) 467-3115

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
23.003718CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Rebman BH LLC CurrentSince Feb 9, 2026 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 13, 2021 Accepting new patients
Lifespan Physician Group, Inc. Medical CurrentSince Jul 13, 2021 Accepting new patients
Healthadvisors LLC CurrentSince Dec 15, 2025 Accepting new patients
Dr Rebman Medical PA CurrentSince Feb 9, 2026 Accepting new patients
Ivy Medical Group PLLC CurrentSince Feb 9, 2026 Accepting new patients

Locations

6 Blackstone Valley Pl
Ste 502
Lincoln, RI 02865
Phone (401) 334-6250

1360 W Main Rd
Middletown, RI 02842
Phone (401) 606-3110

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

Interoperability endpoints

  • Direct secure messaging: krystal.coutcher.1@30907.direct.athenahealth.com
  • Direct secure messaging: krystal.coutcher.1@9000.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1700338407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 COMSTOCK PKWY",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029212345",
            "telephone_number": "203-800-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 CENTERVILLE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864486",
            "telephone_number": "800-659-5411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 Grandview Ave",
            "address_2": "210",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067082507",
            "country_code": "US",
            "telephone_number": "203-754-2535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Adams Pl Ste 305",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "MA",
            "postal_code": "021697456",
            "country_code": "US",
            "telephone_number": "617-302-4194",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Blackstone Valley Pl Ste 502",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "RI",
            "postal_code": "028651102",
            "country_code": "US",
            "telephone_number": "401-334-6262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COUTCHER",
        "first_name": "KRYSTAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "RI",
            "license": "PA01257",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "23.003718",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.