Individual provider Active NPI

Kozeta Jano

  • Pediatric Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1306578356
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
12496 Issued in CT
Practice address
500 Albany Ave
Hartford, CT 06120-2508
Phone
(860) 249-9625
NPI assigned
Jun 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 12496 CT Primary
Maternal Newborn Registered Nurse 163WM0102X RN2306676 MA
Pediatric Nurse Practitioner 363LP0200X RN2306676 MA

Addresses

Primary practice location

500 Albany Ave
Hartford, CT 06120-2508

Mailing address

29 Nutmeg Dr
Worcester, MA 01603-1249

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231204002290 CT Practitioner - Nurse Practitioner 9537517347 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2306676MAMDMaternal Newborn Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Services, Inc. CurrentSince Oct 23, 2023 Accepting new patients
Community Health Services, Inc. CurrentSince Oct 23, 2023 Accepting new patients
Intercommunity, Inc. Past Accepting new patients

Locations

500 Albany Ave
Hartford, CT 06120
Phone (860) 249-9625

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": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1306578356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 NUTMEG DR",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016031249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALBANY AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061202508",
            "telephone_number": "860-249-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANO",
        "first_name": "KOZETA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "12496",
            "primary": true
        },
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "MA",
            "license": "RN2306676",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2306676",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.