Katie Lynn Dziedzic, APRN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

004533 Issued in CT

Practice address

80 Seymour Street
Hartford Hospital Cardiology Dept
Hartford, CT 06102-5037

Phone

(860) 545-4398

NPI assigned

Jan 3, 2011

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

Other identifiers 1

Other names 1

• Katie Lynn Bacon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• MHS Primary Care Inc

  • Family Nurse Practitioner
  • Middletown, CT
  • NPI 1366968182
  NPD
• MHS Primary Care Inc

  • Internal Medicine Physician
  • Essex, CT
  • NPI 1750276655
  NPD
• Middlesex Hospital

  • Community Based Hospice Care Agency
  • Middletown, CT
  • NPI 1003873233
  NPD
• Middlesex Hospital

  • Family Nurse Practitioner
  • Middletown, CT
  • NPI 1972563138

  Acute Care

  NPD

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

{
    "created_epoch": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1093019234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 415933",
            "address_2": "HARTFORD HOSPITAL PROFESSIONAL SERVICES",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415933",
            "telephone_number": "860-545-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL CARDIOLOGY DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-545-4398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIEDZIC",
        "first_name": "KATIE",
        "middle_name": "LYNN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-03",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "004533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004045332",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "BACON",
            "middle_name": "LYNN",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dva Renal Healthcare Inc
• Paul H. Dworkin, MD
• Jessica Beret Dydyn
• Kaylie Elizabeth Dygon, APRN
• Jillian Dziedzic, CRNA
• Christina Marie Eagleson, PA
• Elizabeth L Eakins, LCSW
• Jordan Earl
• Carla Michelle-Ann Earlington, LMSW
• Eastern Rehabilitation Network

• Acute Care Nurse Practitioner in Hartford, CT
• Providers in Hartford, CT by specialty
• Acute Care Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.