Individual provider Active NPI

Patrick Ryan Gondek, APRN

  • Family Nurse Practitioner
  • Torrington, CT
National Provider Identifier
1033673439
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
012867 Issued in CT
Practice address
540 Litchfield St
Torrington, CT 06790-6679
Phone
(860) 496-6650
NPI assigned
Jan 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11000876 FL
Family Nurse Practitioner 363LF0000X 012867 CT Primary

Addresses

Primary practice location

540 Litchfield St
Torrington, CT 06790-6679

Mailing address

9115 Tivoli Chase Dr
Orlando, FL 32829-8116

Other practice location 1

9115 Tivoli Chase Dr
Orlando, FL 32829-8116
Phone (860) 924-8609

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
I20240521002921 CT Practitioner - Nurse Practitioner 9234462664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Charlotte Hungerford HospitalGroup PAC ID 4486557501, 206 clinicians

Practice addresses (Care Compare)

540 Litchfield St
Torrington, CT 06790-6679
Phone (860) 496-9669

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.2 of 100Reported as group
Quality
78.64
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.05 of 100Reported as group
Quality
70.34
Promoting interoperability
100
Improvement activities
40
Cost
75.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012867CTMDFamily Nurse Practitioner
11000876FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte Hungerford Hospital Family CurrentSince Jun 1, 2024 Accepting new patients
The Charlotte Hungerford Hospital CurrentSince Jun 1, 2024 Accepting new patients

Locations

540 Litchfield St
Torrington, CT 06790
Phone (860) 496-6361

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1033673439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9115 TIVOLI CHASE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328298116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 LITCHFIELD ST",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067906679",
            "telephone_number": "860-496-6650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9115 Tivoli Chase Dr",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328298116",
            "country_code": "US",
            "telephone_number": "860-924-8609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONDEK",
        "first_name": "PATRICK",
        "middle_name": "RYAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-30",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11000876",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "012867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrington, CT

Sources for this page

Verify at the official NPI Registry.