Michelle S Koduah, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

7896 Issued in CT

Practice address

400 Capital Blvd
Rocky Hill, CT 06067-3576

Phone

(860) 221-0791

NPI assigned

Sep 8, 2018

Last updated

Feb 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, DC, MD3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Suburban/NRH Medical Rehabilitation IncGroup PAC ID 6507846771, 885 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Griffin Hospital Hospital, Derby, CT, CCN 070031
• Maplewood Park Place Nursing home, Bethesda, MD, CCN 215287

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michelle.koduah@xdr.hhchealthdirect.org

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.

• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187

  DC

  Medicare reassignment Care Compare group NPD
• Careconnectmd Connecticut PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Stamford, CT
  • NPI 1467187336
  Medicare reassignment NPD
• Gaylord Hospital, Inc.

  dba Gaylord Hospital

  • Long Term Care Hospital
  • Wallingford, CT
  • NPI 1730137753
  Medicare reassignment NPD
• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216
  Medicare reassignment NPD
• Healthdrive Medical Services Southeast LLC

  • Nurse Practitioner
  • Columbia, MD
  • NPI 1437930146

  CT, Family

  Medicare reassignment NPD
• Value Based Long Term Care H PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Framingham, MA
  • NPI 1134951676

  CT

  Medicare reassignment NPD
• Medstar Total Elder Care LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Washington, DC
  • NPI 1750752911

  MD

  Medicare reassignment
• Suburban/NRH Medical Rehabilitation Inc

  dba NRH Rehabilitation Network at Bethesda

  • Rehabilitation Clinic/Center
  • Bethesda, MD
  • NPI 1457354748
  Care Compare group
• Hartford Healthcare Medical Group Specialists LLC

  • Customized Equipment (DME)
  • Groton, CT
  • NPI 1295367068
  NPD
• Medstar Medical Group II LLC

  • Anatomic Pathology Physician
  • Washington, DC
  • NPI 1578297503
  NPD

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

• The Griffin Hospital

  • General Acute Care Hospital
  • Derby, CT
  • NPI 1184639973
  Care Compare affiliation
• Maplewood Park Retirement Services Inc

  dba Maplewood Park Place

  • Skilled Nursing Facility
  • Bethesda, MD
  • NPI 1275582140

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1536364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1033692819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CAPITAL BLVD",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060673576",
            "telephone_number": "860-221-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODUAH",
        "first_name": "MICHELLE",
        "middle_name": "S",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-08",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "7896",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CT",
            "license": "119083",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kinsoma Medical Supplies LLC
• Francis Kissi, PHARMD
• Taylor-Leigh Klinger, LPCA
• Nicole B Klughers, N.D., PHARM.D.
• Barbara Bishop Knurek, COTA
• Janice Kolesar, APRN
• Afrinjahan K Kolia, RDMS, RVT
• Koni Aprn Family Practice LLC
• Aida Koni, APRN FNP
• Evan Kraushaar, DMD

• Family Nurse Practitioner in Rocky Hill, CT
• Providers in Rocky Hill, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.