Individual provider Active NPI

Judith Karen Adelstein, APRN

  • Pediatric Nurse Practitioner
  • Fairfield, CT
National Provider Identifier
1013045277
Registry record updated Feb 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
002754 Issued in CT
Practice address
189 Veres St
Fairfield, CT 06824-6447
Phone
(203) 464-7493
NPI assigned
Mar 1, 2007
Last updated
Feb 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 002754 CT Primary

Addresses

Primary practice location

189 Veres St
Fairfield, CT 06824-6447

Mailing address

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002754CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Raphael Healthcare System Affiliated Physicians Inc Past Accepting new patients
Saint Raphael Faculty Physicians Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425081600000",
    "number": "1013045277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102805",
            "telephone_number": "203-384-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 VERES ST",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246447",
            "telephone_number": "203-464-7493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADELSTEIN",
        "first_name": "JUDITH",
        "middle_name": "KAREN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2015-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "002754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.