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

Kathleen Bicknell, PA

Individual provider Physician Assistant · NPI 1205676962

Kathleen Bicknell, PA is a Physician Assistant in Providence, Rhode Island. Qualified in 2024, 2 years ago. Practices with Affinity Physicians LLC, a 734-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
2
Licensed in
RI
In the registry since
2024
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

345 Blackstone Blvd Bldg 100
Providence, RI 02906-4800
Phone: (401) 681-4996
Fax: (401) 921-6569
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA01766 (RI)

Record details

NPI number1205676962
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 30, 2024
Last updated in NPPESMarch 4, 2025
Certification dateMarch 4, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Affinity Physicians Llc. — 734 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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