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

Keren Mariam John, PA-CERTIFIED

Individual provider Physician Assistant · NPI 1285190462

Keren Mariam John, PA-CERTIFIED is a Physician Assistant in New London, Connecticut. Qualified in 2021, 5 years ago. Practices with Fastmed PC, a 176-clinician group and accepts Medicare assignment. Licensed in Connecticut and North Carolina.

Years since qualifying
5
Licensed in
CT, NC
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

365 Montauk Ave
New London, CT 06320-4700
Phone: (860) 442-0711
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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 0010-14522 (NC)
Physician Assistant Taxonomy 363A00000X · Licence 4523 (CT)

Record details

NPI number1285190462
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-CERTIFIED
Sole proprietorNo
NPI enumeratedFebruary 13, 2019
Last updated in NPPESAugust 15, 2025
Certification dateAugust 15, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Fastmed Pc — 176 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in New London