Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kaitlyn Rullo

Individual provider Physician Assistant · NPI 1295465409

Kaitlyn Rullo is a Physician Assistant in Bangor, Maine. Qualified in 2022, 4 years ago. Practices with Eastern Maine Medical Center, a 659-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Maine.

Years since qualifying
4
Licensed in
ME
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

55 Broadway
Bangor, ME 04401-5201
Phone: (207) 947-0469
Fax: (207) 947-5368
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 489 State St, Bangor, ME 04401-6616 — (207) 947-0469

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence PA2440 (ME)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1295465409
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 13, 2022
Last updated in NPPESSeptember 21, 2023
Certification dateSeptember 21, 2023
Mailing address489 State St, Bangor, ME 04401-6616

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Eastern Maine Medical Center — 659 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Bangor