Kwame Acheampong, NP
Individual provider Active NPI Family Nurse Practitioner · Stratford, CT
NPI 1659975969 · NPPES record last updated Aug 27, 2021
Key facts
- NPI
- 1659975969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 9402 (CT)
- Practice address
- 1111 Stratford Ave Apt 404
Stratford, CT 06615-6380 - Phone
- (203) 278-1125
- NPI assigned
- Nov 27, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Step Up Care PC LLC
Proactive Health Care Management LLC
Practice addresses (Care Compare)
111 Westcott Rd
Danielson, CT 06239-2929
Phone (718) 298-4375
475 High St
Mystic, CT 06355-1707
Phone (860) 536-6070
Hospital & facility affiliations
- Griffin Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210901001448 | CT | Practitioner - Nurse Practitioner | 3173929007 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R208334 | MD | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Step Up Care PC LLC | Current |
Accepting new patients | |
| Proactive Health Care Management,LLC | Family | Current |
Accepting new patients |
Locations
111 Westcott Rd
Danielson, CT 06239
Phone (860) 774-9540
845 Paddock Ave
Meriden, CT 06450
Phone (203) 238-2645
475 High St
Mystic, CT 06355
Phone (860) 536-6070
27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R208334 | MD | |
| Registered Nurse | 163W00000X | 114524 | CT | |
| Nurse Practitioner | 363L00000X | 9402 | CT | |
| Family Nurse Practitioner | 363LF0000X | 9402 | CT | Yes |
Addresses
Primary practice location
1111 Stratford Ave Apt 404
Stratford, CT 06615-6380
Mailing address
1111 Stratford Ave Apt 404
Stratford, CT 06615-6380
Phone (203) 278-1125
Other practice location 1
20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242
Other practice location 2
9201 E Mountain View Rd Ste 220
Scottsdale, AZ 85258-5172
Phone (203) 278-1125
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Arizona | Other |
Other providers in Stratford, CT
- A & J Healthcare LLC.
- A-Smile LLC
- Aaa Nursing Care LLC
- Christine Abella
- Denise Ace
- Adedoyin Adebogun
- Advanced Dental Sleep Medicine of Connecticut, PC
- Advanced Psychotherapy Practice LLC
- Agewell Rehab Services PLLC
- Maribel Agosto
All providers in Stratford, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.