Kaitlyn Rahtelli, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3599 Issued in CT

Practice address

50 Old Field Point Rd FL 3
Greenwich, CT 06830-6157

Phone

(203) 862-4000

NPI assigned

Jun 9, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581724800000",
    "number": "1720437833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 OLD FIELD POINT RD FL 3",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 OLD FIELD POINT RD FL 3",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306157",
            "telephone_number": "203-862-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHTELLI",
        "first_name": "KAITLYN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2020-02-15",
        "certification_date": "2020-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "3599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Quintanilla, LMSW
• Patricia Marie Raciti, M.D.
• Radiance Medspa PLLC
• Radiation Services of Greenwich, LLC
• Nicholas Ragovis, M.D.
• Jennifer Rai
• Sabitha Rajan, M.D.
• Courtney Elizabeth Raker, M.D.
• David Daniel Ramos, PT
• Evelyn Ramos

• Medical Physician Assistant in Greenwich, CT
• Providers in Greenwich, 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 Feb 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.