Individual provider Active NPI

Katherine Kennedy, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1821609140
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN2328539 Issued in MA
Practice address
123 Summer St Ste 290N
Worcester, MA 01608-1216
Phone
(508) 368-3130
Fax
(508) 368-3167
NPI assigned
Aug 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN2328539 MA Primary

Addresses

Primary practice location

123 Summer St Ste 290N
Worcester, MA 01608-1216

Mailing address

123 Summer St Ste 290N
Worcester, MA 01608-1216
Phone (508) 368-3130

Other names 1

  • Katherine Misaiko Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20210223000322 MA Practitioner - Nurse Practitioner 6305251430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc CurrentSince Feb 15, 2020 Accepting new patients

Locations

460 Southbridge St
Auburn, MA 01501
Phone (508) 595-2700

24 Newton St
Southborough, MA 01772
Phone (508) 460-3190

123 Summer St
Ste 290N
Worcester, MA 01608
Phone (508) 368-3130

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Interoperability endpoints

  • Direct secure messaging: katherine.misaiko.npi1821609140.reliant@direct.optumcare.masshiway.net

Organizations & group practices 1

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": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1821609140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST STE 290N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-368-3130",
            "fax_number": "508-368-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST STE 290N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-368-3130",
            "fax_number": "508-368-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KATHERINE",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2328539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "MISAIKO",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.