Individual provider Active NPI

Kathia Fonseca

  • Psychiatric/Mental Health Nurse Practitioner
  • Ansonia, CT
National Provider Identifier
1376127696
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10383 Issued in CT
Practice address
435 E Main St
Ansonia, CT 06401-1964
Phone
(203) 736-2601
NPI assigned
May 12, 2021
Last updated
Mar 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10383 CT Primary

Addresses

Primary practice location

435 E Main St
Ansonia, CT 06401-1964

Mailing address

55 Strobel Rd
Trumbull, CT 06611-5512
Phone (203) 644-7655

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
I20221006001409 CT Practitioner - Nurse Practitioner 2163808627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bhcare, Inc.Group PAC ID 5193819308, 33 clinicians

Practice addresses (Care Compare)

435 E Main St
Ansonia, CT 06401-1964
Phone (203) 736-2601

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bhcare, Inc. CurrentSince Jun 14, 2022 Accepting new patients
Alchemy Behavioral Wellness LLC Current Accepting new patients

Locations

435 E Main St
Ansonia, CT 06401
Phone (203) 736-2601

127 Washington Ave
Ste 3W
North Haven, CT 06473

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/BHcare/r4/

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1376127696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 STROBEL RD",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066115512",
            "telephone_number": "203-644-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 E MAIN ST",
            "city": "ANSONIA",
            "state": "CT",
            "postal_code": "064011964",
            "telephone_number": "203-736-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "KATHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-12",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "10383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ansonia, CT

Sources for this page

Verify at the official NPI Registry.