Individual provider Active NPI

Barbara Wadzanayi Hama, NP

  • Nurse Practitioner
  • West Hartford, CT
National Provider Identifier
1245708676
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9748 Issued in CT
Practice address
631 S Quaker LN
West Hartford, CT 06110-1043
Phone
(860) 233-5133
Fax
(860) 233-5212
NPI assigned
Nov 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9748 CT Primary
Hemodialysis Registered Nurse 163WH0500X 26NR14658200 NJ
Adult Health Nurse Practitioner 363LA2200X 26NJ00875500 NJ
Adult Health Nurse Practitioner 363LA2200X 9748 CT

Addresses

Primary practice location

631 S Quaker LN
West Hartford, CT 06110-1043

Mailing address

PO Box 635
Mount Freedom, NJ 07970-0635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, TX, MA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20211015001835 CT Practitioner - Nurse Practitioner 3072911478 Reassigns benefits to 2 organizations
I20250303003320 TX Practitioner - Nurse Practitioner 3072911478 Reassigns benefits to 1 organization
I20260616000564 MA Practitioner - Nurse Practitioner 3072911478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

424 Church St
Nashville, TN 37219-2301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9748CTMDClinical Social Worker
26NR14658200NJMDHemodialysis Registered Nurse
26NJ00875500NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Nurse Practitioner CurrentSince Sep 13, 2021 Accepting new patients

Locations

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

631 S Quaker Ln
West Hartfrd, CT 06110
Phone (860) 231-6130

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Organizations & group practices 3

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": "1541203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1245708676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635",
            "city": "MOUNT FREEDOM",
            "state": "NJ",
            "postal_code": "079700635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S QUAKER LN",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061101043",
            "telephone_number": "860-233-5133",
            "fax_number": "860-233-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMA",
        "first_name": "BARBARA",
        "middle_name": "WADZANAYI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-03",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "9748",
            "primary": true
        },
        {
            "code": "163WH0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hemodialysis",
            "state": "NJ",
            "license": "26NR14658200",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00875500",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "9748",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.