Individual provider Active NPI

Kristine Pantchenko, DNP, APRN, FNP-BC

  • Primary Care Nurse Practitioner
  • Norwalk, CT
National Provider Identifier
1013797505
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
12401 Issued in CT
Practice address
520 West Ave
Norwalk, CT 06850-4034
Phone
(203) 852-2740
NPI assigned
Oct 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X 12401 CT Primary

Addresses

Primary practice location

520 West Ave
Norwalk, CT 06850-4034

Mailing address

520 West Ave
Norwalk, CT 06850-4034
Phone (203) 684-0572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240222001804 CT Practitioner - Nurse Practitioner 3173967759

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

100 Reserve Rd
Danbury, CT 06810-5212

Hospital & facility affiliations

  • Rvnahealth Home health agency, Ridgefield, CT, CCN 077066
  • Danbury Hospital Hospital, Danbury, CT, CCN 070033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. Single Specialty CurrentSince Jan 29, 2024 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

249 Danbury Rd
Wilton, CT 06897
Phone (203) 762-3353

Organizations & group practices 1

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1013797505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 WEST AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068504034",
            "telephone_number": "203-684-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 WEST AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068504034",
            "telephone_number": "203-852-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTCHENKO",
        "first_name": "KRISTINE",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "12401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.