Individual provider Active NPI

Kristine Faulknham Birdsall, M.D.

  • Family Medicine Physician
  • Wethersfield, CT
National Provider Identifier
1245761642
Registry record updated Dec 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
69016 Issued in CT
Practice address
1025 Silas Deane Hwy
Wethersfield, CT 06109-4223
Phone
(860) 696-2400
NPI assigned
Mar 27, 2017
Last updated
Dec 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 69016 CT Primary
Family Medicine Physician 207Q00000X 303175 NY

Addresses

Primary practice location

1025 Silas Deane Hwy
Wethersfield, CT 06109-4223

Mailing address

1025 Silas Deane Hwy
Wethersfield, CT 06109-4223
Phone (860) 696-2400

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
I20210831000542 CT Practitioner - Family Practice 0244502680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group IncGroup PAC ID 1153573902, 257 clinicians

Practice addresses (Care Compare)

1025 Silas Deane Hwy
Wethersfield, CT 06109-4223
Phone (860) 696-2400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.48 of 100Reported as apm
Quality
83.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69016CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc Family Medicine CurrentSince Oct 1, 2021 Accepting new patients
Hartford Healthcare Medical Group, Inc Past Accepting new patients

Locations

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1025 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 696-2296

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: kristine.faulknham@xdr.hhchealthdirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672444800000",
    "number": "1245761642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094223",
            "telephone_number": "860-696-2400",
            "fax_number": "860-972-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094223",
            "telephone_number": "860-696-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRDSALL",
        "first_name": "KRISTINE",
        "middle_name": "FAULKNHAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2022-12-31",
        "certification_date": "2022-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "69016",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "303175",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

Verify at the official NPI Registry.