NPIMap

Individual provider Active NPI

Barbara Kuraitis Pelletier, PA

  • Physician Assistant
  • Waterbury, CT
National Provider Identifier
1780604017
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000465 Issued in CT
Practice address
56 Franklin St
Waterbury, CT 06706-1253
Phone
(203) 709-6004
Fax
(203) 709-3700
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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 000465 CT Primary

Addresses

Primary practice location

56 Franklin St
Waterbury, CT 06706-1253

Mailing address

PO Box 2699
Dept. 200
Hartford, CT 06146-2699
Phone (866) 898-7138

Other identifiers 1

IdentifierTypeStateIssuer
D400009238OtherCTMEDICARE PTAN FOR JOHN DEMPSEY HOSPITAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bpelletier10942@direct.med.uchc.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070216000153 CT Practitioner - Physician Assistant 2860476801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

120 Dowling Way
Uconn Health Ancillary SVCS
Farmington, CT 06030-3800
Phone (860) 679-2784

135 Dowling Way
Farmington, CT 06030-3800
Phone (860) 679-2784

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000465CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Nov 4, 2009 Accepting new patients
State of Connecticut CurrentSince Nov 4, 2009 Accepting new patients
Franklin Medical Group, PC Past Accepting new patients
Middle CT Emergency Physicians LLC Physician Assistant PastSince Oct 22, 2023 Accepting new patients
Hartford Physician Services PC Physician Assistant Past Accepting new patients
Long River Physicians, LLC Past Accepting new patients
CT Emergency Medicine Specialists, LLC Past Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

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 2

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1780604017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "address_2": "DEPT. 200",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061462699",
            "telephone_number": "866-898-7138",
            "fax_number": "616-975-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061253",
            "telephone_number": "203-709-6004",
            "fax_number": "203-709-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "BARBARA",
        "middle_name": "KURAITIS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN FOR JOHN DEMPSEY HOSPITAL",
            "identifier": "D400009238",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bpelletier10942@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "Uconn Medical Group",
            "address_2": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.