Individual provider Active NPI

Shaniya Rosenkrantz, APRN

  • Family Nurse Practitioner
  • Mystic, CT
National Provider Identifier
1497415699
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10474 Issued in CT
Practice address
100 Perkins Farm Dr
Mystic, CT 06355-4037
Phone
(860) 572-8911
NPI assigned
Dec 29, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20220502001293 CT Practitioner - Nurse Practitioner 1456748920 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10474CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince May 1, 2022 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince May 1, 2022 Accepting new patients
Hartford Healthcare Medical Group, Inc Past Accepting new patients

Locations

100 Perkins Farm Dr
Ste 301
Mystic, CT 06355
Phone (860) 572-5400

100 Perkins Farm Dr
Mystic, CT 06355
Phone (860) 572-5455

100 Perkins Farm Dr
Ste 202
Mystic, CT 06355

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: shaniya.tripp@xdr.hhchealthdirect.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10474 CT Primary

Addresses

NPPES NPI Registry

Primary practice location

100 Perkins Farm Dr
Mystic, CT 06355-4037

Mailing address

100 Perkins Farm Dr
Mystic, CT 06355-4037

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 21, 2022.

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1497415699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PERKINS FARM DR",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063554037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PERKINS FARM DR",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063554037",
            "telephone_number": "860-572-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENKRANTZ",
        "first_name": "SHANIYA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-29",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "10474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mystic, CT

Sources for this page

Verify at the official NPI Registry.