Amy Kolaczenko, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

8368 Issued in CT

Practice address

631 S Quaker LN
West Hartford, CT 06110-1026

Phone

(860) 233-5133

NPI assigned

Aug 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  Nurse Practitioner

  Medicare reassignment NPD

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1699320937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MINNIE LN",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061093997",
            "telephone_number": "860-463-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S QUAKER LN",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061101026",
            "telephone_number": "860-233-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLACZENKO",
        "first_name": "AMY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "8368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rolf Knoll, MD
• Hans Knopp, D.O.
• Thomas I Knox, MD
• Christopher John Kochis, APRN
• Karl Eric Koistinen Jr., LCSW
• Konstantia E Papapateras
• Gloria Koo
• Koo's Acupuncture & Herb Clinic P.C.
• Ava Kordansky, MA LMFT
• Daniel Kordansky, MD

• Nurse Practitioner in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.