PATRICK J CREEDON (PA-C) – Surgical Physician Assistant, NPI 1295836104

PATRICK J CREEDON (PA-C) is a healthcare provider. based in Middletown, Connecticut. specializing in Surgical Physician Assistant. They hold the professional credentials PA-C. They hold a License No. 001265 (CT). The NPI Number for PATRICK J CREEDON (PA-C) is 1295836104

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
PATRICK J CREEDON (PA-C)
NPI
1295836104
Phone
(860) 358-4820
Address
28 CRESCENT ST
Enumeration Date
25 September 2006
Last Update Date
12 April 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8603582850
Graduation Year
2002 (24 years ago)
PAC ID
5092612283
Group Practice PAC ID
4082507371
Professional Enrollment ID
I20031216000567
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for PATRICK J CREEDON (PA-C)

  • Middlesex Hospital, 28, Crescent Street, South Farms, Middletown, Middlesex County, Connecticut, 06457, United States

    MIDDLESEX HOSPITAL

    MIDDLETOWN, CT 064573654

    Phone: (860) 358-4820

    Fax: (860) 358-8661

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2003-12-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20031216000567IPhysician AssistantCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06457)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082507371View full group profile
NameSpecialtyState
Nurse PractitionerCT
Nurse PractitionerCT
Physician AssistantCT
Family PracticeCT
Physician AssistantCT
-CT
Family PracticeCT
Family PracticeCT
Physician AssistantMA
General SurgeryCT

Reviews

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Frequently asked questions

What is the registry number for PATRICK J CREEDON (PA-C)?
The registry entry for PATRICK J CREEDON (PA-C) shows NPI 1295836104.
Should I treat PATRICK J CREEDON (PA-C) as an active provider?
Patients and plans typically see PATRICK J CREEDON (PA-C) as active in the national extract.
What does the directory say PATRICK J CREEDON (PA-C) does?
Insurance directories may phrase it differently, but here PATRICK J CREEDON (PA-C) maps to Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
What city is tied to PATRICK J CREEDON (PA-C)?
The directory associates PATRICK J CREEDON (PA-C) with Middletown, Connecticut. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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