Shivanna Subramani Gonzalez, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

009553 Issued in CT

Practice address

504 Wolcott Rd
Wolcott, CT 06716-2461

Phone

(203) 725-5339

NPI assigned

Nov 24, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Shivanna Subramani Other name

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ptsma IncGroup PAC ID 7911800180, shared by 11 NPIs, 173 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: subramanis@tmwhawcp-ct.direct.office.nextgen.com
• Direct secure messaging: shivanna.subramani.gonzalez.1@31946.direct.athenahealth.com

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.

• The Modern Woman Health & Wellness Center PLLC

  • Family Nurse Practitioner
  • Wolcott, CT
  • NPI 1801599295

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Physicians for Women'S Health LLC

  • Obstetrics & Gynecology Physician
  • Rocky Hill, CT
  • NPI 1801826680

  Multi-Specialty

  Medicare reassignment NPD
• TMW Wellness PLLC

  • Mental Health Counselor
  • Wolcott, CT
  • NPI 1700580198

  Multi-Specialty

  Medicare reassignment NPD
• WCT Behavioral Health & Medication Management PLLC

  • Family Nurse Practitioner
  • Waterbury, CT
  • NPI 1285391474

  Multi-Specialty

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1457758179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 WOLCOTT RD STE C",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162462",
            "telephone_number": "860-714-2913",
            "fax_number": "860-714-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 WOLCOTT RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162461",
            "telephone_number": "203-725-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBRAMANI GONZALEZ",
        "first_name": "SHIVANNA",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-24",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "5993",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "5993",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "009553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "005993",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIVANNA",
            "last_name": "SUBRAMANI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ana M Silva, LCSW
• Skye Jera Zeller
• Monika Smielewska, D.M.D.
• Lorna Stamat
• Jenna Sue Stanish
• David M Suhocki, PA
• Superior Health Care of CT, LLC
• Michael F Swierczynski, D.C.
• Taylor Nicole Tardif
• The Modern Woman Health & Wellness Center PLLC

• Family Nurse Practitioner in Wolcott, CT
• Providers in Wolcott, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.