Individual provider Active NPI

Christina Devi Drelichowski, APRN

  • Nurse Practitioner
  • Waterbury, CT
National Provider Identifier
1154951341
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8427 Issued in CT
Practice address
64 Robbins St
Waterbury, CT 06708-2600
Phone
(203) 573-6205
NPI assigned
Jan 16, 2020
Last updated
Jul 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 8427 CT
Nurse Practitioner 363L00000X 8427 CT Primary

Addresses

Primary practice location

64 Robbins St
Waterbury, CT 06708-2600

Mailing address

282 Lake Shore Dr
Middlebury, CT 06762-3400
Phone (203) 577-7592

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
I20200408000718 CT Practitioner - Nurse Practitioner 7810326196 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.01 of 100Reported as group
Quality
71.79
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8427CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Connecticut PC Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
Northeast Emergency Medicine Specialists, LLC Emergency Medicine CurrentSince Mar 3, 2024 Accepting new patients

Locations

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

81 Meriden Ave
Southington, CT 06489
Phone (860) 224-5540

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

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, 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": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1154951341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 LAKE SHORE DR",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067623400",
            "telephone_number": "203-577-7592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 ROBBINS ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082600",
            "telephone_number": "203-573-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRELICHOWSKI",
        "first_name": "CHRISTINA",
        "middle_name": "DEVI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "8427",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "8427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.