Individual provider Active NPI

Raymond Charles Kaiser, PA

  • Medical Physician Assistant
  • Manchester, CT
National Provider Identifier
1871579318
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
000765 Issued in CT
Practice address
256 N Main St
Manchester, CT 06042-2004
Phone
(860) 646-8595
Fax
(860) 645-3216
NPI assigned
Dec 16, 2005
Last updated
Apr 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000765 CT
Medical Physician Assistant 363AM0700X 000765 CT Primary

Addresses

Primary practice location

256 N Main St
Manchester, CT 06042-2004

Mailing address

PO Box 1086
Hartford Medical Group
Wilbraham, MA 01095-7086
Phone (508) 595-0531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061016000127 CT Practitioner - Physician Assistant 4789680786 Reassigns benefits to 2 organizations
I20200428001239 RI Practitioner - Physician Assistant 4789680786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Associates LLCGroup PAC ID 9234156985, 208 clinicians

Practice addresses (Care Compare)

365 Montauk Ave
New London, CT 06320-4700
Phone (860) 442-0711

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000765CTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Hospitalists of New England PC Physician Assistant CurrentSince May 1, 2012 Accepting new patients

Locations

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

819 Worcester St
Ste 3
Springfield, MA 01151
Phone (413) 543-6820

25 Wells St
Westerly, RI 02891
Phone (401) 348-3325

Interoperability endpoints

  • Direct secure messaging: rkaiser329904@direct.ynhh.org

Organizations & group practices 3

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.

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": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1871579318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1086",
            "address_2": "HARTFORD MEDICAL GROUP",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "010957086",
            "telephone_number": "508-595-0531",
            "fax_number": "508-829-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 N MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422004",
            "telephone_number": "860-646-8595",
            "fax_number": "860-645-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISER",
        "first_name": "RAYMOND",
        "middle_name": "CHARLES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000765",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "000765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.