Active NPI
Kristin McGregor, MD
- Pediatrics Physician
- Bloomfield, CT
National Provider Identifier
1235152307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036875
- Practice address
- 57 Jolley Dr
Bloomfield, CT 06002-3062 - Phone
- (860) 243-5225
- Fax
- (860) 769-6757
- NPI assigned
- Jul 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 036875 | CT | |
| Pediatrics Physician | 208000000X | 036875 | CT | Primary |
Addresses
Primary practice location
57 Jolley Dr
Bloomfield, CT 06002-3062
Mailing address
57 Jolley Dr
Bloomfield, CT 06002-3062
Phone (860) 243-5225
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001368754 | Medicaid | CT | |
| 010036875CT01 | Other | CT | ANTHEM BLUE SHIELD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kmcgregor16493@direct.stfranciscare.org | Direct |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131119001719 | CT | Order and Referring Only - Pediatric Medicine | 3375779457 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collins Medical Associates 2 PC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- kristin.mcgregor.1@27673.direct.athenahealth.com
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1235152307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 JOLLEY DR",
"city": "BLOOMFIELD",
"state": "CT",
"postal_code": "060023062",
"telephone_number": "860-243-5225",
"fax_number": "860-769-6757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 JOLLEY DR",
"city": "BLOOMFIELD",
"state": "CT",
"postal_code": "060023062",
"telephone_number": "860-243-5225",
"fax_number": "860-769-6757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGREGOR",
"first_name": "KRISTIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "CT",
"license": "036875",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CT",
"license": "036875",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001368754",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE SHIELD",
"identifier": "010036875CT01",
"state": "CT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kmcgregor16493@direct.stfranciscare.org",
"affiliation": "N",
"endpointDescription": "Saint Francis Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "57 Jolley Dr",
"city": "Bloomfield",
"state": "CT",
"country_code": "US",
"postal_code": "060023062",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bloomfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.