Peter T Krenicky, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

13523 Issued in CT

Practice address

477 Connecticut Blvd
Ste 205
East Hartford, CT 06108

Phone

(860) 528-9645

Fax

(860) 528-6366

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1497795900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 CONNECTICUT BLVD",
            "address_2": "STE 205",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "06108",
            "telephone_number": "860-528-9645",
            "fax_number": "860-528-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 CONNECTICUT BLVD",
            "address_2": "STE 205",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "06108",
            "telephone_number": "860-528-9645",
            "fax_number": "860-528-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRENICKY",
        "first_name": "PETER",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "13523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001135235",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF CT",
            "identifier": "010013523CT",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "013523",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne Knight
• Kenya Sherita Knowlin
• Auline Kong
• Steven K Kousournas, DMD
• Ola Krajewski, MA, BCBA, LBA
• Heather Krom
• Leroy W Krumperman Jr., M.D.
• Justyna Krynski, CRNA
• Leonard Edward Kulicki, M.D.
• Tracy L Kunkel, APRN

• Ophthalmology Physician in East Hartford, CT
• Providers in East Hartford, CT by specialty
• Ophthalmology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.