Individual provider Active NPI

Anxhela Kulla

  • Medical Physician Assistant
  • Waterbury, CT
National Provider Identifier
1033748975
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5086 Issued in CT
Practice address
1981 E Main St Unit 2
Waterbury, CT 06705-1853
Phone
(203) 709-5520
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5086 CT Primary

Addresses

Primary practice location

1981 E Main St Unit 2
Waterbury, CT 06705-1853

Mailing address

1981 E Main St Unit 2
Waterbury, CT 06705-1853
Phone (203) 709-5520

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
I20210407001258 CT Practitioner - Physician Assistant 0648687756 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group IncGroup PAC ID 1153573902, 257 clinicians

Practice addresses (Care Compare)

201 N Mountain Rd
Plainville, CT 06062-1848
Phone (860) 224-5416

22 Pine St
Bristol, CT 06010-6948
Phone (860) 584-8291

55 Meriden Ave
Suite 1D
Southington, CT 06489-3239
Phone (860) 276-5144

61 Pomeroy Ave
Meriden, CT 06450-7482
Phone (203) 694-5340

98 Main St
Southington, CT 06489-2500
Phone (860) 827-6080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5086CTMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Jul 1, 2023 Accepting new patients
Midstate Medical Group, PC Past Accepting new patients
Hartford Healthcare Medical Group, Inc Past Accepting new patients

Locations

22 Pine St
Ste 104
Bristol, CT 06010
Phone (860) 314-2002

280 S Main St
Cheshire, CT 06410
Phone (203) 271-3296

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

201 N Mountain Rd
Ste 203
Plainville, CT 06062
Phone (860) 827-4199

462 Queen St
Ste 301
Southington, CT 06489
Phone (860) 621-6704

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1981 E Main St
Unit 2
Waterbury, CT 06705
Phone (203) 709-5520

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

Interoperability endpoints

  • Direct secure messaging: anxhela.kulla@xdr.hhchealthdirect.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1033748975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1981 E MAIN ST UNIT 2",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051853",
            "telephone_number": "203-709-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1981 E MAIN ST UNIT 2",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051853",
            "telephone_number": "203-709-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULLA",
        "first_name": "ANXHELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "5086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.