Individual provider Active NPI

Cristiana Clark, APRN

  • Acute Care Nurse Practitioner
  • New Britain, CT
National Provider Identifier
1346732716
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
7643 Issued in CT
Practice address
100 Grand St
New Britain, CT 06052
Phone
(860) 224-5691
NPI assigned
Jun 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 7643 CT Primary
Registered Nurse 163W00000X 121533 CT

Addresses

Primary practice location

100 Grand St
New Britain, CT 06052

Mailing address

825 Orange St Apt 2
New Haven, CT 06511-2507
Phone (817) 681-8674

Other practice location 1

20 York St
New Haven, CT 06510-3220
Phone (203) 688-2366

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
I20180925003726 CT Practitioner - Nurse Practitioner 6002167368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Grand St
New Britain, CT 06052-2016
Phone (860) 224-6623

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as group
Quality
83.66
Promoting interoperability
100
Improvement activities
40
Cost
66.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7643CTMDPediatric Dentist
121533CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Sep 17, 2018 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Sep 17, 2018 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Past Accepting new patients

Locations

100 Grand St
Ste E119
New Britain, CT 06052
Phone (860) 224-5305

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

Interoperability endpoints

  • Direct secure messaging: cclark194211@direct.ynhh.org

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": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1346732716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 ORANGE ST APT 2",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112507",
            "telephone_number": "817-681-8674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRAND ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "06052",
            "telephone_number": "860-224-5691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-2366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CRISTIANA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "7643",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "121533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Britain, CT

Sources for this page

Verify at the official NPI Registry.