Individual provider Active NPI

Diana Kolcz, PSY.D.

  • Clinical Neuropsychologist
  • Hartford, CT
National Provider Identifier
1215542436
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
3943 Issued in CT
Practice address
200 Retreat Ave
Hartford, CT 06102-3101
Phone
(860) 545-7000
NPI assigned
Sep 14, 2020
Last updated
Sep 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 3943 CT Primary

Addresses

Primary practice location

200 Retreat Ave
Hartford, CT 06102-3101

Mailing address

200 Retreat Ave
Hartford, CT 06102-3101
Phone (860) 545-7000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201121000076 CT Practitioner - Neuropsychiatry 4385055409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neuropsychiatry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin D. Oliveira Psy D LLCGroup PAC ID 4385931195, 5 clinicians

Practice addresses (Care Compare)

10 N Main St
Suite 1
West Hartford, CT 06107-1968
Phone (860) 519-5227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Martin D Oliveira Psy D LLC Clinical Neuropsychologist CurrentSince Feb 27, 2021 Accepting new patients

Locations

10 N Main St
Ste 1
West Hartford, CT 06107
Phone (860) 415-6463

15 N Main St
Ste 100
West Hartford, CT 06107
Phone (214) 532-3757

Interoperability endpoints

  • Direct secure messaging: diana.kolcz@xdr.hhchealthdirect.org

Organizations & group practices 1

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": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1215542436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061023101",
            "telephone_number": "860-545-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061023101",
            "telephone_number": "860-545-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLCZ",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "3943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.