Kimberly C. Riquelme, D.O.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

54151 Issued in CT

Practice address

1353 Gold Star Hwy
Groton, CT 06340

Phone

(860) 449-9947

NPI assigned

Aug 9, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kimberly C. Schreck Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

New York College of Osteo Medicine of New York Institute of Technology, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

86.54

Promoting interoperability

99.98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kriquelme588597@direct.ynhh.org
• Direct secure messaging: kimberly.riquelme@xdr.hhchealthdirect.org

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.

• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Natchaug Hospital, Inc.

  • Psychiatric Hospital
  • Mansfield Center, CT
  • NPI 1295811321
  Medicare reassignment NPD
• Windham Community Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Willimantic, CT
  • NPI 1023191467
  Medicare reassignment NPD
• Northeast Medical Group, Inc

  • Cardiovascular Disease Physician
  • Fairfield, CT
  • NPI 1366745267
  NPD

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1619282191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 GOLD STAR HWY",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063402739",
            "telephone_number": "860-449-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 GOLD STAR HWY",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340",
            "telephone_number": "860-449-9947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Research Pkwy",
            "address_purpose": "LOCATION",
            "city": "Old Saybrook",
            "state": "CT",
            "postal_code": "064754211",
            "country_code": "US",
            "telephone_number": "860-510-0163",
            "fax_number": "860-510-0486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIQUELME",
        "first_name": "KIMBERLY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-09",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "54151",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "54151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "54151",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SCHRECK",
            "middle_name": "C.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julia Gwen Rice, OTR
• Cheryl Marie Richard
• Tania Richard, CNM/WHNP
• Russell Jennings Rider, IDC
• Felipe Rios
• Erica M. Rivera, RD
• Riverside Counseling, LLC
• Martha E. Robarge, C.O.T.A.
• Robert Barnett D.C. LLC
• Robert Barnett D.C. LLC

• Child & Adolescent Psychiatry Physician in Groton, CT
• Providers in Groton, CT by specialty
• Child & Adolescent Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.