Individual provider Active NPI

Kent J Kilbourn, PA

  • Physician Assistant
  • Norwalk, CT
National Provider Identifier
1710902986
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
00902 Issued in CT
Practice address
148 East Ave
Suite 3D
Norwalk, CT 06851-5721
Phone
(203) 853-0003
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 00902 CT Primary

Addresses

Primary practice location

148 East Ave
Suite 3D
Norwalk, CT 06851-5721

Mailing address

85 Seymour St
Ste 1003
Hartford, CT 06106-5529
Phone (203) 853-0003

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
I20060320000554 CT Practitioner - Physician Assistant 3870500648 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians
Hartford HospitalGroup PAC ID 2567366016, 1,040 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

2800 Main St
Bridgeport, CT 06606-4201

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 545-7500

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025
  • St Vincent'S Medical Center Hospital, Bridgeport, CT, CCN 070028

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
902CTMDPsychologist
000902CTMDMarriage & Family Therapist
00902CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Jan 1, 2022 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Sep 1, 2019 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Jan 1, 2022 Accepting new patients
Hartford Hospital CurrentSince Oct 1, 2005 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Sep 1, 2019 Accepting new patients
Elite Brain & Spine of Connecticut, PLLC PastSince Jun 1, 1998 Accepting new patients

Locations

85 Seymour St
Ste 1003
Hartford, CT 06106
Phone (860) 246-4260

435 Lewis Ave
Ste 101
Meriden, CT 06451
Phone (203) 694-5925

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

Interoperability endpoints

  • Direct secure messaging: kent.kilbourn@xdr.hhchealthdirect.org

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 and National Provider Directory roles.

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1710902986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST",
            "address_2": "STE 1003",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065529",
            "telephone_number": "203-853-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 EAST AVE",
            "address_2": "SUITE 3D",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515721",
            "telephone_number": "203-853-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILBOURN",
        "first_name": "KENT",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "00902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.