Individual provider Active NPI

Kayla Kriscenski, NP

  • Adult Health Nurse Practitioner
  • Avon, CT
National Provider Identifier
1609321801
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
8811 Issued in CT
Practice address
44 Dale Rd
Avon, CT 06001-4315
Phone
(860) 674-8830
Fax
(860) 674-8984
NPI assigned
Aug 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2265093 MA
Adult Health Nurse Practitioner 363LA2200X 8811 CT Primary

Addresses

Primary practice location

44 Dale Rd
Avon, CT 06001-4315

Mailing address

44 Dale Rd
Avon, CT 06001-4320
Phone (860) 674-8830

Other practice location 1

41 Mall Rd
Lahey Hospital and Medical Center
Burlington, MA 01805-0001
Phone (781) 744-8000

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
I20220606001435 CT Practitioner - Nurse Practitioner 5597043158 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3692

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare, PC Nurse Practitioner CurrentSince Jul 1, 2022 Accepting new patients
University of Connecticut Health Center Adult Health CurrentSince Nov 1, 2022 Accepting new patients
University of Connecticut Health Center CurrentSince Nov 1, 2022 Accepting new patients
Prime Healthcare (Sleep Lab) CurrentSince Jul 1, 2022 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

44 Dale Rd
Avon, CT 06001
Phone (860) 674-8830

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

30 Jordan Ln
Wethersfield, CT 06109
Phone (860) 263-0253

Interoperability endpoints

  • Direct secure messaging: kkriscenski63296@direct.med.uchc.edu

Organizations & group practices 5

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.

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": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1609321801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 DALE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014320",
            "telephone_number": "860-674-8830",
            "fax_number": "860-674-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 DALE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014315",
            "telephone_number": "860-674-8830",
            "fax_number": "860-674-8984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_2": "Lahey Hospital and Medical Center",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018050001",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRISCENSKI",
        "first_name": "KAYLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-18",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2265093",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "8811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.