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

Mrs. Kelly Theo Rouleau, PA

Individual provider Physician Assistant · NPI 1750510533

Mrs. Kelly Theo Rouleau, PA is a Physician Assistant in Portsmouth, New Hampshire. Graduated from University of New England, College of Osteo Medicine in 2009, 17 years ago. Practices with Northeast Dermatology Associates PC, a 84-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Maine and New Hampshire.

Years since qualifying
17
Trained at
University of New England, College of Osteo Medicine
Licensed in
ME, NH
In the registry since
2009
Specialties on file
2
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

155 Borthwick Ave Ste 201
Portsmouth, NH 03801
Phone: (978) 691-5690
Fax: (603) 410-4679
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 519 Us Route 1 Unit 2, York, ME 03909 — (978) 691-5690
  • 23 Hampton Rd, Exeter, NH 03833 — (978) 691-5690

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0734 (NH)
Physician Assistant Taxonomy 363A00000X · Licence PA1660 (ME)

Record details

NPI number1750510533
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJuly 14, 2009
Last updated in NPPESMarch 4, 2021
Certification dateMarch 4, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
Graduated 2009 (17 years in practice)
Group practice Northeast Dermatology Associates Pc — 84 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Portsmouth