Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Justin Champagne, PA-C

Individual provider Physician Assistant · NPI 1073697108

Mr. Justin Champagne, PA-C is a Physician Assistant in Waterbury, Connecticut. Qualified in 2005, 21 years ago. Practices with Diagnostic Radiology Associates LLC, a 24-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
21
Licensed in
CT
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

134 Grandview Ave
Waterbury, CT 06708-2507
Phone: (203) 756-8911
Fax: (203) 574-0548
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 001721 (CT)
Physician Assistant Taxonomy 363A00000X · Licence 001721 (CT)

Record details

NPI number1073697108
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 25, 2006
Last updated in NPPESJanuary 12, 2012

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Diagnostic Radiology Associates Llc — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Waterbury