Individual provider Active NPI

Kristen Rose Wojewudski, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Farmington, CT
National Provider Identifier
1376008706
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN02003 Issued in RI
Practice address
263 Farmington Avenue
Farmington, CT 06030-8063
Phone
(860) 679-8080
Fax
(860) 679-1430
NPI assigned
Feb 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2100X RN RI
Acute Care Nurse Practitioner 363LA2100X APRN02003 RI Primary

Addresses

Primary practice location

263 Farmington Avenue
Farmington, CT 06030-8063

Mailing address

263 Farmington Avenue
Farmington, CT 06030-8063
Phone (860) 679-8080

Other practice location 1

Kent Hospital
455 Toll Gate Road
Warwick, RI 02886
Phone (401) 737-7000

Other practice location 2

Rhode Island Hospital
593 Eddy Street
Providence, RI 02903
Phone (401) 444-4000

Other identifiers 1

IdentifierTypeStateIssuer
XXXXXXMedicaidRI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kwojewudski62028@direct.med.uchc.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190405000558 RI Practitioner - Nurse Practitioner 9739420498 Reassigns benefits to 1 organization
I20230421000802 CT Practitioner - Nurse Practitioner 9739420498 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)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3692

263 Farmington Ave
Farmington, CT 06030-8082

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10722CTMDMassage Therapist
RNRIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center Single Specialty CurrentSince Dec 30, 2022 Accepting new patients
University of Connecticut Health Center Single Specialty CurrentSince Dec 30, 2022 Accepting new patients
Lifespan Physician Group, Inc. Single Specialty CurrentSince May 13, 2019 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince May 13, 2019 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

164 Summit Ave
Bldg 2ND
Providence, RI 02906
Phone (401) 749-2930

593 Eddy St
Providence, RI 02903

593 Eddy St
#6
Providence, RI 02903
Phone (401) 793-9166

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1376008706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060308063",
            "telephone_number": "860-679-8080",
            "fax_number": "860-679-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060308063",
            "telephone_number": "860-679-8080",
            "fax_number": "860-679-1430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Kent Hospital",
            "address_2": "455 Toll Gate Road",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "02886",
            "country_code": "US",
            "telephone_number": "401-737-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Rhode Island Hospital",
            "address_2": "593 Eddy Street",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "02903",
            "country_code": "US",
            "telephone_number": "401-444-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOJEWUDSKI",
        "first_name": "KRISTEN",
        "middle_name": "ROSE",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "RI",
            "license": "RN",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "RI",
            "license": "APRN02003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XXXXXX",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwojewudski62028@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060308063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.