Individual provider Active NPI

Kristin Levesque, P.A.-C

  • Medical Physician Assistant
  • Bristol, CT
National Provider Identifier
1669822532
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3574 Issued in CT
Practice address
41 Brewster Rd
Bristol, CT 06010-5161
Phone
(860) 584-8291
NPI assigned
Jun 21, 2016
Last updated
Jan 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3574 CT Primary

Addresses

Primary practice location

41 Brewster Rd
Bristol, CT 06010-5161

Mailing address

41 Brewster Rd
Bristol, CT 06010-5161

Other identifiers 1

IdentifierTypeStateIssuer
1669822532MedicaidCT

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
I20160924000096 CT Practitioner - Physician Assistant 2860789401 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bristol Hospital Multi Specialty Group, Inc.Group PAC ID 9032014758, 148 clinicians

Practice addresses (Care Compare)

41 Brewster Rd
Bristol, CT 06010-5161
Phone (860) 585-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Aug 5, 2019 Accepting new patients

Locations

22 Pine St
Bristol, CT 06010
Phone (860) 229-8346

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

Interoperability endpoints

  • Direct secure messaging: kristin.somerville@xdr.hhchealthdirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1669822532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 BREWSTER RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 BREWSTER RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105161",
            "telephone_number": "860-584-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVESQUE",
        "first_name": "KRISTIN",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "3574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669822532",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.