Individual provider Active NPI

Elizabeth T Kamlani, APRN

  • Adult Health Nurse Practitioner
  • Fairfield, CT
National Provider Identifier
1093718876
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
003040 Issued in CT
Practice address
575 Winnepoge Dr
Fairfield, CT 06825-2562
Phone
(203) 763-9452
NPI assigned
May 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 003040 CT Primary

Addresses

Primary practice location

575 Winnepoge Dr
Fairfield, CT 06825-2562

Mailing address

575 Winnepoge Dr
Fairfield, CT 06825-2562
Phone (203) 763-9452

Other identifiers 1

IdentifierTypeStateIssuer
004247799MedicaidCT

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
I20050308000646 CT Practitioner - Nurse Practitioner 0143274621 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11398TNMDPhysical Therapist
003040CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paradigm Medical Care, LLC Adult Health CurrentSince Sep 18, 2008 Accepting new patients
Absolute Outcomes, LLC Past Accepting new patients
NP Care, LLC Past Accepting new patients
NP Care of Tennessee, LLC Past Accepting new patients
NP Care, LLC Past Accepting new patients

Locations

400 Mill Plain Rd
Fairfield, CT 06824
Phone (203) 255-3573

3325 State Route 35
Hazlet, NJ 07730
Phone (732) 264-5800

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1093718876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 WINNEPOGE DR",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068252562",
            "telephone_number": "203-763-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 WINNEPOGE DR",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068252562",
            "telephone_number": "203-763-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMLANI",
        "first_name": "ELIZABETH",
        "middle_name": "T",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "003040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004247799",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.