Individual provider Active NPI

Michele A Marek, APRN

  • Family Nurse Practitioner
  • West Hartford, CT
National Provider Identifier
1144324229
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1184 Issued in CT
Practice address
41 N Main St
Ste 300
West Hartford, CT 06107-1972
Phone
(860) 313-0448
Fax
(860) 313-1464
NPI assigned
Sep 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 03-274181 CT
Nurse Practitioner 363L00000X 001184 CT
Family Nurse Practitioner 363LF0000X 1184 CT Primary

Addresses

Primary practice location

41 N Main St
Ste 300
West Hartford, CT 06107-1972

Mailing address

41 N Main St
Ste 300
West Hartford, CT 06107-1972
Phone (860) 313-0448

Other identifiers 2

IdentifierTypeStateIssuer
004272100MedicaidCT
001184OtherCTCONNECTICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmarek16855@direct.stfranciscare.org Direct

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
I20070308000546 CT Practitioner - Nurse Practitioner 8426151655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Connecticut School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kiefer Counseling, LLCGroup PAC ID 1254707367, 4 clinicians

Practice addresses (Care Compare)

14 Maple St
Terryville, CT 06786-5220
Phone (203) 232-5971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
001184CTMDMental Health Counselor
03-274181CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kiefer Counseling LLC CurrentSince Oct 1, 2022 Accepting new patients
Eileen C. Comia, MD, LLC Nurse Practitioner PastSince Mar 22, 2013 Accepting new patients

Locations

14 Maple St
Terryville, CT 06786
Phone (203) 232-5971

Organizations & group practices 2

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1144324229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 N MAIN ST",
            "address_2": "STE 300",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071972",
            "telephone_number": "860-313-0448",
            "fax_number": "860-313-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 N MAIN ST",
            "address_2": "STE 300",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071972",
            "telephone_number": "860-313-0448",
            "fax_number": "860-313-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAREK",
        "first_name": "MICHELE",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "03-274181",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "001184",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "1184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004272100",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "001184",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmarek16855@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Saint Francis Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "41 N Main St",
            "address_2": "Ste 300",
            "city": "West Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061071972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.