Individual provider Active NPI

Nanci E Kaczegowicz, APRN

  • Family Nurse Practitioner
  • Trumbull, CT
National Provider Identifier
1487657276
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
002926 Issued in CT
Practice address
115 Technology Dr
Suite B-106
Trumbull, CT 06611-6337
Phone
(203) 452-1411
Fax
(203) 452-1412
NPI assigned
May 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 002926 CT Primary

Addresses

Primary practice location

115 Technology Dr
Suite B-106
Trumbull, CT 06611-6337

Mailing address

44 Marsh Rd
Easton, CT 06612-1927
Phone (203) 374-9630

Other identifiers 1

IdentifierTypeStateIssuer
004242442MedicaidCT

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
I20040405001253 CT Practitioner - Nurse Practitioner 0749273985 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Behavioral Health Center for Counseling and Learning LLCGroup PAC ID 8729313135, 27 clinicians
Key Therapy LLCGroup PAC ID 6204185010, 9 clinicians

Practice addresses (Care Compare)

1000 Bridgeport Ave
Suite 202
Shelton, CT 06484-4669
Phone (203) 712-9998

731 Main St
Suite 122
Monroe, CT 06468-2872
Phone (203) 261-7090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
002926CTMDMarriage & Family Therapist
2926CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Gi PLLC Family CurrentSince Jul 1, 2022 Accepting new patients
Compassionate Care Counseling LLC CurrentSince Aug 18, 2022 Accepting new patients
Behavioral Health Center for Counseling & Learning, LLC CurrentSince Aug 18, 2022 Accepting new patients
Key Therapy LLC CurrentSince Jan 31, 2023 Accepting new patients
Litchfield County Gastroenterology Associates, LLC Past Accepting new patients
NP Care, LLC Past Accepting new patients
MLZ Health Care Associates, LLC Past Accepting new patients
Orthopaedic Specialty Group, P.C. PastSince Jan 31, 2023 Accepting new patients

Locations

85 Seymour St
Ste 1000
Hartford, CT 06106
Phone (860) 246-2571

984 Southford Rd
Middlebury, CT 06762
Phone (203) 758-2400

731 Main St
Ste 122
Monroe, CT 06468
Phone (203) 261-7090

30 Waterchase Dr
Rocky Hill, CT 06067
Phone (860) 257-4131

1000 Bridgeport Ave
Ste 202
Shelton, CT 06484
Phone (203) 712-9998

Interoperability endpoints

  • Direct secure messaging: nanci.kaczegowicz@xdr.hhchealthdirect.org

Organizations & group practices 8

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1487657276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 MARSH RD",
            "city": "EASTON",
            "state": "CT",
            "postal_code": "066121927",
            "telephone_number": "203-374-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 TECHNOLOGY DR",
            "address_2": "SUITE B-106",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066116337",
            "telephone_number": "203-452-1411",
            "fax_number": "203-452-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZEGOWICZ",
        "first_name": "NANCI",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "002926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004242442",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

Verify at the official NPI Registry.