Shirley Kuan, MSN, AGNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

9166 Issued in CT

Practice address

968 Fairfield Ave
Bridgeport, CT 06605-1116

Phone

(203) 330-6000

Fax

(203) 334-0398

NPI assigned

Oct 6, 2020

Reactivated

Apr 18, 2022

Last updated

Apr 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: shirley.kuan.p1@direct.scfhc.nextgenshare.com

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.

• South Central Family Health Center

  dba Huntington Park Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Huntington Park, CA
  • NPI 1669799896
  Medicare reassignment NPD
• South Central Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1396891909
  NPD
• South Central Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1649792615
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1255938940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "968 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06605",
            "telephone_number": "203-330-6000",
            "fax_number": "203-334-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "968 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051116",
            "telephone_number": "203-330-6000",
            "fax_number": "203-334-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUAN",
        "first_name": "SHIRLEY",
        "credential": "MSN, AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "deactivation_date": "2022-03-18",
        "reactivation_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "9166",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "9166",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "153503",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "9166",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Krasnica, M.D.
• Nastajjia Krementz, MD
• Brian Krilivsky, R.D.
• Carly Krisavage, PHYSICIAN ASSISTANT
• Susan Krissel, CNM
• Eric A Kuczynski, MD
• Brenda I Kulikowski, MSN; CERTIFIED NURSE
• Reuben Praharsh Kumar, M.B.B.S
• Rajeshkumar Kumaraswami, M.D.
• Grace Kunjukunju, MD

• Adult Health Nurse Practitioner in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Adult Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.

Verify at the official NPI Registry.