Kristin Elizabeth Kiczuk, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9238 Issued in CT

Practice address

255 Hempstead St
New London, CT 06320-6204

Phone

(860) 443-2896

Fax

(860) 442-5909

NPI assigned

Sep 29, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kristin Elizabeth Baker Former name

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

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gaylord Hospital, Inc.Group PAC ID 1153224191, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
• Gaylord Hospital Inc Long-term care hospital, Wallingford, CT, CCN 072003

Merit-based Incentive Payment System (MIPS)

Final score

82.25 of 100Reported as group

Quality

63.07

Improvement activities

40

Cost

77.51

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gaylord Hospital, Inc.

  dba Gaylord Hospital

  • Long Term Care Hospital
  • Wallingford, CT
  • NPI 1730137753
  Medicare reassignment Care Compare group NPD
• United Community and Family Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Norwich, CT
  • NPI 1467482539
  Medicare reassignment NPD
• Summit Counseling LLC

  • Community/Behavioral Health Agency
  • Preston, CT
  • NPI 1871874537
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Gaylord Hospital, Inc.

  dba Gaylord Hospital

  • Long Term Care Hospital
  • Wallingford, CT
  • NPI 1730137753

  Long-term care hospital

  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1578778726
  Care Compare affiliation

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1548579253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HEMPSTEAD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206204",
            "telephone_number": "860-443-2896",
            "fax_number": "860-442-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 HEMPSTEAD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206204",
            "telephone_number": "860-443-2896",
            "fax_number": "860-442-5909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICZUK",
        "first_name": "KRISTIN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "BAKER",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Beklen Kerimoglu, M.D.
• David Allen Kerns Jr., PA-C
• Amzad Khan, M.D.
• Angabeen S Khan, MD
• Amit Khanna, MD
• Allison Kilmer, APRN
• Caitlin E Kimberlin, LMSW
• Elliot Harold Kimmel, DDS,MS
• Brandie King
• Randi L Kington, APRN

• Clinical Social Worker in New London, CT
• Providers in New London, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.