Katelyn Madeline Wirtz

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

9910 Issued in CT

Practice address

285 Main St
West Haven, CT 06516-7307

Phone

(203) 503-3000

NPI assigned

Jun 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwirtz402700@direct.ynhh.org

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.

• Cornell Scott Hill Health Corporation

  • Federally Qualified Health Center (FQHC)
  • New Haven, CT
  • NPI 1902921380
  Medicare reassignment NPD

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1083282891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVENUE",
            "address_2": "CREDENTIALING SPECIALIST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3174",
            "fax_number": "203-503-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 MAIN ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065167307",
            "telephone_number": "203-503-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTZ",
        "first_name": "KATELYN",
        "middle_name": "MADELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "9910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Williams
• Elizabeth H Winebrenner, BCBA
• Laurie Ann Wingard, P.T.
• Kimberly Ann Winslow, CRNA
• Jason M Winters, DMD
• Lindsey Brooke Witham, APRN
• Danielle Patricia Wojtaszek, PHARMD
• Jacquelyn Lou Wolf, RN
• Katie Wolf, RN
• Stanley Jack Wolfe, DDS

• Psychiatric/Mental Health Nurse Practitioner in West Haven, CT
• Providers in West Haven, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.