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CARLY KRISAVAGE PHYSICIAN ASSISTANT
NPI 1629564729
Physician Assistant in Bridgeport, CT

Active since July 02, 2018PECOS EnrolledAccepts Medicare Assignment
161 BOSTON AVE, BRIDGEPORT, CT 06610(203) 333-4400(203) 334-0729 Get Directions Write a Review

NPPES record last updated: January 13, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 13, 2020, Jul 2, 2018 (2 updates tracked since 2018).

About Carly Krisavage Physician Assistant NPPES

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

CARLY KRISAVAGE PHYSICIAN ASSISTANT (NPI 1629564729) is an individual physician assistant in Bridgeport, Connecticut, licensed in Connecticut (4141) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS, maintains a secondary practice location in Fairfield, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1629564729
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCARLY KRISAVAGECredential: PHYSICIAN ASSISTANT
Location Address161 BOSTON AVEBridgeport, CT 06610-1662
Mailing Address11 Stonefield DrProspect, CT 06712-1744 · (203) 592-4376
Phone(203) 333-4400
Fax(203) 334-0729
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJuly 2, 2018
Last NPPES UpdateJanuary 13, 20202 updates tracked since enumeration
✔ NPI 1629564729 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CT · 4141
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.
161 BOSTON AVE, Bridgeport, CT 06610
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Other Names 1

Professional Name (2)Carly Krisavage Pa-c

Secondary Practice Location 1

Location 11918 Black Rock TpkeFairfield, CT 06825-3543 · Phone (203) 583-8400 · Fax (203) 583-4777

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

Carly Krisavage Physician Assistant 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 ID6305195801
PECOS Enrollment IDI20180816001402
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06610 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
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.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER LEE
Dentist (General Practice)
161 BOSTON AVE
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 873-0598
SPH BRIDGEPORT, LLC
Dentist (General Practice)
161 BOSTON AVE
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 873-0598
SELVATOR GJOKA DMD
Dentist
161 BOSTON AVE
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 873-0598
QUENTIN MEDICAL GROUP, LLC
Clinic/Center (Urgent Care)
161 BOSTON AVE
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 333-4400
SPH ENTERPRISE LLC
Dentist (General Practice)
161 BOSTON AVE
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 873-0598
DR. WASEEM SHAHID M.D.
Family Medicine
161 BOSTON AVE
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 333-4400

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 Carly Krisavage's NPI number?

The NPI number for Carly Krisavage is 1629564729. It was assigned to this individual provider in the NPPES registry on July 2, 2018. The provider is also known as Carly Krisavage Pa-C.

Where is Carly Krisavage located?

Carly Krisavage practices at 161 Boston Ave, Bridgeport, CT 06610. The listed phone number is (203) 333-4400.

What is Carly Krisavage's specialty?

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

Is Carly Krisavage enrolled in Medicare?

Yes. Carly Krisavage 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.

When was this NPI record last updated?

The NPPES record for Carly Krisavage was last updated on January 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.