Individual provider Active NPI

Kristen U. Stephens, PA

  • Medical Physician Assistant
  • Middletown, CT
National Provider Identifier
1174598445
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1490 Issued in CT
Practice address
28 Crescent St
Middletown, CT 06457-3654
Phone
(860) 358-8016
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1490 CT Primary

Addresses

Primary practice location

28 Crescent St
Middletown, CT 06457-3654

Mailing address

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-8016

Other identifiers 1

IdentifierTypeStateIssuer
001490OtherCTCT LICENSE #

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
I20050110001110 CT Practitioner - Physician Assistant 2961450515 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Urgent Care Centers LLCGroup PAC ID 7618242777, 201 clinicians

Practice addresses (Care Compare)

1025 Silas Deane Hwy
Wethersfield, CT 06109-4223
Phone (860) 696-2400

35 Talcottville Rd
Vernon, CT 06066-5261
Phone (860) 787-5774

351 N Frontage Rd
New London, CT 06320-2628
Phone (860) 865-0934

385 W Main St
Avon, CT 06001-4357
Phone (860) 777-6977

54 Hazard Ave
Enfield, CT 06082-3845
Phone (860) 787-5780

752 Washington St
Middletown, CT 06457-2904
Phone (860) 613-5377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Mar 20, 2014 Accepting new patients
University of Connecticut Health Center CurrentSince Mar 20, 2014 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Sep 1, 2017 Accepting new patients
Middlesex Hospital Past Accepting new patients
Middlesex Hospital Medical PastSince Sep 1, 2001 Accepting new patients

Locations

385 W Main St
Avon, CT 06001
Phone (860) 777-1280

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

5 Founders St
Ste 202
Willimantic, CT 06226
Phone (860) 456-3997

Organizations & group practices 6

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1174598445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "KRISTEN",
        "middle_name": "U.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "1490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LICENSE #",
            "identifier": "001490",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.