Individual provider Active NPI

Marina Kloyzner, M.D.

  • Emergency Medicine Physician
  • Middletown, CT
National Provider Identifier
1225394273
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
053933 Issued in CT
Practice address
45 Crescent Street
Middlesex Hospital Department of Emergency Medicine
Middletown, CT 06457
Phone
(860) 358-6693
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 053933 CT Primary

Addresses

Primary practice location

45 Crescent Street
Middlesex Hospital Department of Emergency Medicine
Middletown, CT 06457

Mailing address

45 Crescent Street
Middlesex Hospital Department of Emergency Medicine
Middletown, CT 06457
Phone (860) 358-6693

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
I20151211002287 CT Practitioner - Emergency Medicine 9234430430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Northeastern Ohio University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middlesex HospitalGroup PAC ID 5092611731, 231 clinicians

Practice addresses (Care Compare)

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
053933CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince Nov 1, 2015 Accepting new patients
Middlesex Hospital CurrentSince Nov 1, 2015 Accepting new patients

Locations

80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878

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

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1225394273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CRESCENT STREET",
            "address_2": "MIDDLESEX HOSPITAL DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "06457",
            "telephone_number": "860-358-6693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CRESCENT STREET",
            "address_2": "MIDDLESEX HOSPITAL DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "06457",
            "telephone_number": "860-358-6693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOYZNER",
        "first_name": "MARINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "053933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.