Individual provider Active NPI

Ann Kabza, FNP-C

  • Family Nurse Practitioner
  • Old Saybrook, CT
National Provider Identifier
1649645292
Registry record updated Feb 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12.006493 Issued in CT
Practice address
519 Boston Post Rd
Old Saybrook, CT 06475-1526
Phone
(860) 388-1145
NPI assigned
Dec 8, 2015
Last updated
Feb 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6493 CT
Family Nurse Practitioner 363LF0000X 12.006493 CT Primary

Addresses

Primary practice location

519 Boston Post Rd
Old Saybrook, CT 06475-1526

Mailing address

519 Boston Post Rd
Old Saybrook, CT 06475-1526
Phone (860) 388-1145

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
I20160603000565 CT Practitioner - Nurse Practitioner 2062702061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MC Diagnostic of Connecticut, P.C.Group PAC ID 0941382113, 66 clinicians

Practice addresses (Care Compare)

1057 Boston Post Rd
Guilford, CT 06437-2644
Phone (866) 389-2727

3514 Main St
Coventry, CT 06238-1551
Phone (866) 389-2727

519 Boston Post Rd
Old Saybrook, CT 06475-1526
Phone (800) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6493CTMDOccupational Therapist
12.006493CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MC Diagnostic of Connecticut, P.C. Family CurrentSince Feb 23, 2017 Accepting new patients
Minuteclinic Primary Care Connecticut PLLC Family CurrentSince Jun 4, 2025 Accepting new patients

Locations

3514 Main St
Coventry, CT 06238
Phone (860) 298-5925

2639 Main St
Glastonbury, CT 06033
Phone (860) 389-2727

519 Boston Post Rd
Old Saybrook, CT 06475
Phone (860) 388-1045

323 Cromwell Ave
Rocky Hill, CT 06067
Phone (860) 384-9666

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1449532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644019200000",
    "number": "1649645292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 BOSTON POST RD",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751526",
            "telephone_number": "860-388-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 BOSTON POST RD",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751526",
            "telephone_number": "860-388-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABZA",
        "first_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-08",
        "last_updated": "2022-02-05",
        "certification_date": "2022-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6493",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12.006493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Saybrook, CT

Sources for this page

Verify at the official NPI Registry.