Individual provider Active NPI

Kaitlyn Zugibe, PHYSICIAN ASSISTANT

  • Physician Assistant
  • West Hartford, CT
National Provider Identifier
1932684974
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4257 Issued in CT
Practice address
65 Memorial Rd Ste 508
West Hartford, CT 06107-4233
Phone
(860) 696-2925
NPI assigned
Sep 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022600 NY
Physician Assistant 363A00000X 25MP00578000 NJ
Physician Assistant 363A00000X 4257 CT Primary

Addresses

Primary practice location

65 Memorial Rd Ste 508
West Hartford, CT 06107-4233

Mailing address

65 Memorial Rd Ste 508
West Hartford, CT 06107-4233
Phone (860) 696-2925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 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
I20181226001855 NY Practitioner - Physician Assistant 8527303346
I20240808003109 CT Practitioner - Physician Assistant 8527303346 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

280 S Main St
Cheshire, CT 06410-3112

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022600NYMDOccupational Therapist
4257CTMDPhysician Assistant
25MP00578000NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Sep 15, 2024 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Sep 15, 2024 Accepting new patients
Hartford Hospital CurrentSince Sep 15, 2024 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Sep 15, 2024 Accepting new patients

Locations

280 S Main St
Ste 103
Cheshire, CT 06410

100 Perkins Farm Dr
Ste 303
Mystic, CT 06355
Phone (860) 886-1433

30 Buxton Farm Rd
Ste 230
Stamford, CT 06905
Phone (203) 212-4191

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

65 Memorial Rd
Ste 410
West Hartford, CT 06107
Phone (860) 368-1648

65 Memorial Rd
Ste 508
West Hartford, CT 06107

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: kaitlyn.zugibe@xdr.hhchealthdirect.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1932684974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 MEMORIAL RD STE 508",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061074233",
            "telephone_number": "860-696-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MEMORIAL RD STE 508",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061074233",
            "telephone_number": "860-696-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUGIBE",
        "first_name": "KAITLYN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022600",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00578000",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.