Individual provider Active NPI

Kelly Quijano, APRN

  • Primary Care Nurse Practitioner
  • Torrington, CT
National Provider Identifier
1467196121
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
010559 Issued in CT
Practice address
895 East Main Street
Torrington, CT 06790-3918
Phone
(860) 489-1291
Fax
(860) 489-1804
NPI assigned
Apr 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 10559 CT
Gerontology Nurse Practitioner 363LG0600X 10559 CT
Primary Care Nurse Practitioner 363LP2300X 010559 CT Primary

Addresses

Primary practice location

895 East Main Street
Torrington, CT 06790-3918

Mailing address

895 East Main Street
Torrington, CT 06790-3918
Phone (860) 489-1291

Other practice location 1

38 Old Ridgebury Rd
Danbury, CT 06810-5128
Phone (860) 748-2041

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
I20220720000447 CT Practitioner - Nurse Practitioner 4284015405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Connecticut Health CenterGroup PAC ID 3678472016, 624 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Charlotte Hungerford Hospital Hospital, Torrington, CT, CCN 070011

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Jul 5, 2022 Accepting new patients
Northwest Connecticut Physicians LLC Adult Health CurrentSince Jul 17, 2022 Accepting new patients
University of Connecticut Health Center Adult Health CurrentSince Jul 5, 2022 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

117 Albany Tpke
Canton, CT 06019
Phone (860) 658-3444

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

836 Hopmeadow St
Simsbury, CT 06070
Phone (860) 651-3519

895 E Main St
Torrington, CT 06790
Phone (860) 489-1291

Interoperability endpoints

  • Direct secure messaging: kquijano16584@direct.med.uchc.edu

Organizations & group practices 4

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 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": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1467196121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 EAST MAIN STREET",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067903918",
            "telephone_number": "860-489-1291",
            "fax_number": "860-489-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 EAST MAIN STREET",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067903918",
            "telephone_number": "860-489-1291",
            "fax_number": "860-489-1804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38 Old Ridgebury Rd",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "068105128",
            "country_code": "US",
            "telephone_number": "860-748-2041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUIJANO",
        "first_name": "KELLY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "10559",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "10559",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "010559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrington, CT

Sources for this page

Verify at the official NPI Registry.