Individual provider Active NPI

Kristina Valle, PA-C

  • Physician Assistant
  • Farmington, CT
National Provider Identifier
1215309885
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5031 Issued in CT
Practice address
263 Farmington Avenue
Farmington, CT 06030-4038
Phone
(860) 679-6600
Fax
(860) 679-6604
NPI assigned
Oct 22, 2015
Last updated
Feb 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 52959 CA
Physician Assistant 363A00000X 5031 CT Primary

Addresses

Primary practice location

263 Farmington Avenue
Farmington, CT 06030-4038

Mailing address

263 Farmington Avenue
Farmington, CT 06030-4038
Phone (860) 679-6600

Other practice location 1

133 Scovill St Ste 308
Waterbury, CT 06706-1127
Phone (203) 709-6680

Other practice location 2

7695 Cardinal Ct Ste 240
San Diego, CA 92123-3357
Phone (858) 277-9378

Other names 1

  • Kristina Lines Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kvalle62352@direct.med.uchc.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160418000887 CA Practitioner - Physician Assistant 7719285212 Reassigns benefits to 1 organization
I20210122000952 CT Practitioner - Physician Assistant 7719285212 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3692

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52959CAMDAmbulatory Care Pharmacist
5031CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Apr 2, 2018 Accepting new patients
University of Connecticut Health Center CurrentSince Nov 18, 2022 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Physician Assistant CurrentSince Apr 2, 2018 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

2929 Health Center Dr
San Diego, CA 92123
Phone (858) 939-6531

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

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

133 Scovill St
Ste 308
Waterbury, CT 06706
Phone (203) 709-5900

Interoperability endpoints

  • Direct secure messaging: kristinaliner@wcemdi.allscriptsdirect.net
  • Direct secure messaging: kvalle506063@xdr.hhchealthdirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1215309885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060304038",
            "telephone_number": "860-679-6600",
            "fax_number": "860-679-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060304038",
            "telephone_number": "860-679-6600",
            "fax_number": "860-679-6604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 Scovill St Ste 308",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067061127",
            "country_code": "US",
            "telephone_number": "203-709-6680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7695 Cardinal Ct Ste 240",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921233357",
            "country_code": "US",
            "telephone_number": "858-277-9378",
            "fax_number": "858-277-9370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLE",
        "first_name": "KRISTINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-22",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52959",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "5031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kvalle62352@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060304038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "LINES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.