Kate B Mastronunzio, PA-C
Individual provider Active NPI Physician Assistant · Stafford Springs, CT
NPI 1730375403 · NPPES record last updated Nov 12, 2009
Key facts
- NPI
- 1730375403
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 001967 (CT)
- Practice address
- 201 Chestnut Hill Rd
Johnson Memorial Hospital Emergency Room
Stafford Springs, CT 06076-4005 - Phone
- (860) 684-8185
- Fax
- (860) 684-8285
- NPI assigned
- Sep 17, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.01 of 100
- Quality
- 71.79
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071121000358 | CT | Practitioner - Physician Assistant | 3779518436 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001967 | CT | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johnson Professional Associates, PC | Past | Accepting new patients |
Interoperability endpoints
- kate.mastronunzio@xdr.hhchealthdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001967 | CT | Yes |
Addresses
Primary practice location
201 Chestnut Hill Rd
Johnson Memorial Hospital Emergency Room
Stafford Springs, CT 06076-4005
Mailing address
PO Box 789
Ludlow, MA 01056-0789
Phone (413) 509-1000
Other providers in Stafford Springs, CT
- Donna Lowney
- Ryan F Makuck
- Christine Malcolm
- Holly Margaret Marek
- Martha Abromaitis Dba Stafford Physical Therapy
- Megan McCollum
- Mindful Matters Counseling, LLC
- Chloe Molitoris
- Nes Medical Services of Northern Connecticut, P.C.
- Nutmeg Healthcare Associates, P.C.
All providers in Stafford Springs, CT · Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.