Victoria Kaczynski, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01157 Issued in RI

Practice address

3461 S County TRL Ste 202
East Greenwich, RI 02818-1463

Phone

(337) 640-1471

NPI assigned

Jun 12, 2019

Last updated

Jan 23, 2025By the provider in NPPES

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

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Robert K Dyer MD Dermatology LLCGroup PAC ID 8123290491, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South County Hospital Inc Hospital, Wakefield, RI, CCN 410008

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tjedson@scriderm.emadirect.md

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.

• Robert K Dyer MD Dermatology LLC

  • Dermatology Physician
  • East Greenwich, RI
  • NPI 1528348521
  Medicare reassignment Care Compare group
• Rhode Island Dermatology & Cosmetic Center LLC

  • Specialist
  • Lincoln, RI
  • NPI 1972676021
  Medicare reassignment
• Rhode Island Dermatology Obs

  • Ambulatory Surgical Clinic/Center
  • Lincoln, RI
  • NPI 1235202201
  NPD (past)
• South County Family Medicine Inc.

  • Family Medicine Physician
  • Hope Valley, RI
  • NPI 1225041064
  NPD (past)
• Fall River Dermatology PC

  • Dermatology Physician
  • Fall River, MA
  • NPI 1811232820
  NPD (past)

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

• South County Hospital Healthcare System

  • General Acute Care Hospital
  • Wakefield, RI
  • NPI 1952366106
  Care Compare affiliation

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1760041610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 VILLAGE SQUARE DR",
            "city": "SOUTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028792292",
            "telephone_number": "401-738-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3461 S COUNTY TRL STE 202",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028181463",
            "telephone_number": "337-640-1471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 Village Square Dr",
            "address_purpose": "LOCATION",
            "city": "South Kingstown",
            "state": "RI",
            "postal_code": "028792292",
            "country_code": "US",
            "telephone_number": "401-738-4323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KACZYNSKI",
        "first_name": "VICTORIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in East Greenwich, RI
• Providers in East Greenwich, RI by specialty
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.