Individual provider Active NPI

Kristin Adams Sikes, APRN

  • Pediatric Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1073596615
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
002741 Issued in CT
Practice address
2 Church St S
Suite 404
New Haven, CT 06519-1717
Phone
(203) 764-6747
Fax
(203) 764-6748
NPI assigned
Nov 29, 2005
Last updated
Apr 5, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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 002741 CT Primary

Addresses

Primary practice location

2 Church St S
Suite 404
New Haven, CT 06519-1717

Mailing address

2 Church St S
Suite 404
New Haven, CT 06519-1717
Phone (203) 764-6747

Other identifiers 1

IdentifierTypeStateIssuer
004238540MedicaidCT

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
I20100630000018 CT Practitioner - Nurse Practitioner 8820129158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002741CTMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Apr 18, 2010 Accepting new patients
Yale University CurrentSince Apr 18, 2010 Accepting new patients
Yale University Past Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

Organizations & group practices 3

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1073596615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST S",
            "address_2": "SUITE 404",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191717",
            "telephone_number": "203-764-6747",
            "fax_number": "203-764-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST S",
            "address_2": "SUITE 404",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191717",
            "telephone_number": "203-764-6747",
            "fax_number": "203-764-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIKES",
        "first_name": "KRISTIN",
        "middle_name": "ADAMS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "002741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004238540",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.