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KENNETH CUSHING BOTELHO PA-C
NPI 1184977514
Physician Assistant in East Providence, RI

Active since October 23, 2012PECOS EnrolledAccepts Medicare Assignment
450 VETERANS MEMORIAL PKWY BLDG 9, EAST PROVIDENCE, RI 02914(401) 435-5533(401) 435-3586 Get Directions Write a Review

NPPES record last updated: May 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 16, 2025, Jan 25, 2022 (2 updates tracked since 2022).

About Kenneth Cushing Botelho Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH CUSHING BOTELHO PA-C (NPI 1184977514) is an individual physician assistant in East Providence, Rhode Island, licensed in Rhode Island (PA00716) and active in the NPI registry since October 2012. He is enrolled in Medicare PECOS, is affiliated with Essentia Health St Mary's Medical Center, and maintains a secondary practice location in Hermantown.

NPPES Registry Identity

NPI1184977514
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameKENNETH CUSHING BOTELHOCredential: PA-C
Location Address450 VETERANS MEMORIAL PKWY BLDG 9East Providence, RI 02914-5300
Mailing Address450 Veterans Memorial Pkwy Bldg 9East Providence, RI 02914-5300 · (401) 435-5533 · Fax (401) 435-3586
Phone(401) 435-5533
Fax(401) 435-3586
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateOctober 23, 2012
Last NPPES UpdateMay 16, 20252 updates tracked since enumeration
NPPES CertifiedMay 16, 2025
✔ NPI 1184977514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in RI · PA00716✔ Licensed in MN · 15285
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
450 VETERANS MEMORIAL PKWY BLDG 9, East Providence, RI 02914
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Secondary Practice Location 1

Location 14855 W Arrowhead RdHermantown, MN 55811-3936 · Phone (218) 786-3540

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kenneth Cushing Botelho Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6901030766
PECOS Enrollment IDI20250523000221
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
342 services182 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
61 services60 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
56 services45 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
52 services45 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
35 services35 patients
Telephone medical discussion with physician, 21-30 minutes 99443
This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.
26 services20 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Essentia Health St Mary's Medical Center

Acute Care Hospitals · Duluth, MN
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240002
Location402 East Second StreetDuluth, MN 55805 · St. Louis County
Emergency services Birthing friendly

Essentia Health Duluth

Acute Care Hospitals · Duluth, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240019
Location502 East Second StreetDuluth, MN 55805 · St. Louis County
Birthing friendly

Essentia Health Moose Lake

Critical Access Hospitals · Moose Lake, MN
OwnershipGovernment - Hospital District or Authority
CMS Certification Number241350
Location4572 County Road 61Moose Lake, MN 55767 · Carlton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02914 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$72.93 typical visit price
range $18.92 – $144.38
Typical copayment $18.23 (range $4.73 – $36.09)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%5,450 patients5/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
23%891 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%364 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
58%1,561 patients3/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
99%1,561 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
22%1,561 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
26%1,561 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Botelho's NPI number?

The NPI number for Kenneth Botelho is 1184977514. It was assigned to this individual provider in the NPPES registry on October 23, 2012.

Where is Kenneth Botelho located?

Kenneth Botelho practices at 450 Veterans Memorial Pkwy Bldg 9, East Providence, RI 02914. The listed phone number is (401) 435-5533.

What is Kenneth Botelho's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kenneth Botelho enrolled in Medicare?

Yes. Kenneth Botelho is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kenneth Botelho accept?

Health plans from Medica and Sanford Health Plan list Kenneth Botelho as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kenneth Botelho affiliated with any hospitals?

According to CMS data, Kenneth Botelho is affiliated with Essentia Health St Mary's Medical Center, Essentia Health Duluth and Essentia Health Moose Lake.

When was this NPI record last updated?

The NPPES record for Kenneth Botelho was last updated on May 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.