Individual provider Active NPI

Susan M Kamovitch, APRN

  • Family Nurse Practitioner
  • Fairfield, CT
National Provider Identifier
1609879485
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
001830 Issued in CT
Practice address
206 South Street
SMR Health Care
Fairfield, CT 06824
Phone
(203) 255-3367
NPI assigned
May 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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 001830 CT Primary

Addresses

Primary practice location

206 South Street
SMR Health Care
Fairfield, CT 06824

Mailing address

206 South Street
Fairfield, CT 06824-5906
Phone (203) 255-3367

Other practice location 1

1 Cellini Pl Ste 102
West Haven, CT 06516-1666
Phone (203) 932-6481

Other identifiers 1

IdentifierTypeStateIssuer
004236718MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address susan.kamovitch@xdr.hhchealthdirect.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001830CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
NP Care, LLC Past Accepting new patients
DME Healthcare LLC Past Accepting new patients
Susan Kamovitch Family PastSince Jan 1, 1990 Accepting new patients
NP Care, LLC Past Accepting new patients
MLZ Health Care Associates, LLC Past Accepting new patients

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.

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": "1678665600000",
    "number": "1609879485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 SOUTH STREET",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245906",
            "telephone_number": "203-255-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 SOUTH STREET",
            "address_2": "SMR HEALTH CARE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "06824",
            "telephone_number": "203-255-3367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Cellini Pl Ste 102",
            "address_purpose": "LOCATION",
            "city": "West Haven",
            "state": "CT",
            "postal_code": "065161666",
            "country_code": "US",
            "telephone_number": "203-932-6481",
            "fax_number": "203-932-4051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMOVITCH",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "001830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236718",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "susan.kamovitch@xdr.hhchealthdirect.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1 Cellini Pl Ste 102",
            "city": "West Haven",
            "state": "CT",
            "country_code": "US",
            "postal_code": "065161666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.