Individual provider Active NPI

Kimberly Vanpelt, PHYSICIAN ASSISTANT

  • Surgical Physician Assistant
  • Hartford, CT
National Provider Identifier
1346481983
Registry record updated Nov 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
3315 Issued in CT
Practice address
282 Washington St
Hartford, CT 06106-3322
Phone
(860) 545-9000
NPI assigned
Mar 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00213100 NJ
Physician Assistant 363A00000X 3315 CT
Surgical Physician Assistant 363AS0400X 3315 CT Primary

Addresses

Primary practice location

282 Washington St
Hartford, CT 06106-3322

Mailing address

10 Columbus Blvd
Hartford, CT 06106-1976
Phone (607) 592-4771

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kvanpelt55313@connecticutchildrens.direct-ci.com

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
I20150917000814 CT Practitioner - Physician Assistant 9436208535 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00213100NJMDPhysician Assistant
3315CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children'S Specialty Group, Inc. Physician Assistant CurrentSince Sep 15, 2020 Accepting new patients
Connecticut Children'S Medical Center Past Accepting new patients
Garden State Surgical Center, LLC Past Accepting new patients

Locations

105 Newtown Rd
#A
Danbury, CT 06810
Phone (860) 545-9395

105 Newtown Rd
Danbury, CT 06810
Phone (203) 744-4343

399 Farmington Ave
Ste 300
Farmington, CT 06032
Phone (860) 284-0220

310 Western Blvd
Glastonbury, CT 06033
Phone (860) 837-9877

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

31 Seymour St
Fl 4
Hartford, CT 06106

282 Washington St
Ste 1A
Hartford, CT 06106

1281 E Main St
Ste 3
Stamford, CT 06902
Phone (860) 545-9200

191 Post Rd W
#1
Westport, CT 06880

Interoperability endpoints

  • Direct secure messaging: kvanpelt55313@connecticutchildrens.direct-ci.com

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": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669334400000",
    "number": "1346481983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 COLUMBUS BLVD",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061061976",
            "telephone_number": "607-592-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322",
            "telephone_number": "860-545-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANPELT",
        "first_name": "KIMBERLY",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-11",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00213100",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3315",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "3315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kvanpelt55313@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.