Individual provider Active NPI

Kimberly Ann Santora, PH.D.

  • Psychologist
  • Farmington, CT
National Provider Identifier
1477856078
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
004631 Issued in CT
Practice address
10 Talcott Notch
Farmington, CT 06032
Phone
(860) 679-6700
Fax
(860) 679-6736
NPI assigned
Dec 21, 2010
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Psychologist 103T00000X 10029 MA
Psychologist 103T00000X 004631 CT Primary

Addresses

Primary practice location

10 Talcott Notch
Farmington, CT 06032

Mailing address

263 Farmington Avenue
Farmington, CT 06030-1104
Phone (860) 679-6700

Other practice location 1

190 Lenox St
Norwood, MA 02062-3416
Phone (203) 668-9976

Other practice location 2

263 Farmington Avenue
Farmington, CT 06030-1104
Phone (860) 679-6700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ksantora74399@direct.med.uchc.edu

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240401002051 CT Practitioner - Clinical Psychologist 6608214333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
10029MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Jan 21, 2024 Accepting new patients
State of Connecticut Psychologist Current Accepting new patients
State of Connecticut CurrentSince Jan 21, 2024 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

10 Talcott Notch Rd
Farmington, CT 06032
Phone (860) 679-6700

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1292889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1477856078",
    "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": "060301104",
            "telephone_number": "860-679-6700",
            "fax_number": "860-679-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TALCOTT NOTCH",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06032",
            "telephone_number": "860-679-6700",
            "fax_number": "860-679-6736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "190 Lenox St",
            "address_purpose": "LOCATION",
            "city": "Norwood",
            "state": "MA",
            "postal_code": "020623416",
            "country_code": "US",
            "telephone_number": "203-668-9976",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Farmington Avenue",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060301104",
            "country_code": "US",
            "telephone_number": "860-679-6700",
            "fax_number": "860-679-6736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTORA",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-21",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "10029",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "004631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksantora74399@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "10 Talcott Notch",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.