Kristen Ann Kotsopoulos, PA-C
Physician Assistant in Worcester, MA. Individual provider (NPI-1).
NPI number1124634720
StatusActive
Last updated in NPPESMar 30, 2021
Details
- NPI
- 1124634720
- Entity type
- Individual (NPI-1)
- Name
- Kristen Ann Kotsopoulos
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 18, 2020
- Certification date
- Mar 30, 2021
- Last updated
- Mar 30, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA7777 | MA | Yes |
| 363A00000X | Physician Assistant | – | – |
Practice location
55 Lake Ave NWorcester, MA 01655-0002
Phone 508-334-0605 · Fax 508-856-1574
Mailing address
Po Box 415348Boston, MA 02241-5348
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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