Organization Active NPI

Nova MD Wellness Clinic PLLC

  • Internal Medicine Physician
  • Norwalk, CT
National Provider Identifier
1205794252
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NOVA MD WELLNESS CLINIC PLLC
Practice address
148 East Ave Ste 1G1
Norwalk, CT 06851-5727
Phone
(203) 684-2050
Fax
(203) 941-1427
NPI assigned
Jan 9, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Authorized official

Name
Jasmina Krstic, MDNPI 1801118252
Title
President
Phone
(347) 326-0623

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

148 East Ave Ste 1G1
Norwalk, CT 06851-5727

Mailing address

148 East Ave Ste 1G1
Norwalk, CT 06851-5727
Phone (203) 684-2050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260225002618 CT Part B Supplier - Clinic/Group Practice 2062993215 Receives reassigned benefits from 1 practitioner
Practice locations: Norwalk, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D2296807Nova MD Wellness Clinic PLLC148 East Ave, Ste 1G1, Norwalk, CT 06851Certificate of waiverJan 4, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1767916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1205794252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 EAST AVE STE 1G1",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515727",
            "telephone_number": "203-684-2050",
            "fax_number": "203-941-1427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 EAST AVE STE 1G1",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515727",
            "telephone_number": "203-684-2050",
            "fax_number": "203-941-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA MD WELLNESS CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-09",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "KRSTIC",
        "authorized_official_first_name": "JASMINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-326-0623",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.