Individual provider Active NPI

Petronella Stoltz, APRN

  • Pediatric Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1477527968
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
003263 Issued in CT
Practice address
282 Washington St
Hartford, CT 06106-3322
Phone
(860) 545-9850
Fax
(860) 545-9800
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 003263 CT Primary

Addresses

Primary practice location

282 Washington St
Hartford, CT 06106-3322

Mailing address

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9850

Other identifiers 1

IdentifierTypeStateIssuer
004252011MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pstoltz6544@connecticutchildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 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
I20050929000790 CT Practitioner - Nurse Practitioner 5890720643 Reassigns benefits to 1 organization
I20230309001503 MA Practitioner - Nurse Practitioner 5890720643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9000

84 Willimansett St
Suite C
South Hadley, MA 01075-3097
Phone (860) 545-9395

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3263CTMDProfessional Counselor
003263CTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children'S Specialty Group, Inc. Pediatrics CurrentSince Aug 14, 2011 Accepting new patients
Connecticut Children'S Specialty Group, Inc. Pediatrics CurrentSince Aug 14, 2011 Accepting new patients

Locations

60 Hartland St
East Hartford, CT 06108

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

282 Washington St
Ste 1B
Hartford, CT 06106

10 Columbus Blvd
Fl 4
Hartford, CT 06106
Phone (860) 837-5560

282 Washington St
Ste B
Hartford, CT 06106
Phone (860) 545-9395

191 Post Rd W
#1
Westport, CT 06880

84 Willimansett St
South Hadley, MA 01075
Phone (413) 533-8501

84 Willimansett St
Ste C
South Hadley, MA 01075
Phone (860) 545-9395

Interoperability endpoints

  • Direct secure messaging: pstoltz6544@connecticutchildrens.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1477527968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322",
            "telephone_number": "860-545-9850",
            "fax_number": "860-545-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322",
            "telephone_number": "860-545-9850",
            "fax_number": "860-545-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLTZ",
        "first_name": "PETRONELLA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "003263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004252011",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pstoltz6544@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.