Individual provider Active NPI

Kristin McGregor, MD

  • Pediatrics Physician
  • Bloomfield, CT
National Provider Identifier
1235152307
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036875 Issued in CT
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

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
001368754MedicaidCT
010036875CT01OtherCTANTHEM BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131119001719 CT Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3375779457

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Collins Medical Associates 2 PC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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

Verify at the official NPI Registry.