Individual provider Active NPI

Travis Pyka, APRN FNP-C CEN

  • Family Nurse Practitioner
  • Bridgeport, CT
National Provider Identifier
1699388728
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10298 Issued in CT
Practice address
2979 Main St
Bridgeport, CT 06606-4284
Phone
(036) 835-1002
NPI assigned
Aug 28, 2020
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 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 10298 CT Primary
Emergency Registered Nurse 163WE0003X 161300 CT

Addresses

Primary practice location

2979 Main St
Bridgeport, CT 06606-4284

Mailing address

2979 Main St
Bridgeport, CT 06606-4284
Phone (036) 835-1002

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
I20220219000062 CT Practitioner - Nurse Practitioner 9739573601 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Danbury HospitalGroup PAC ID 1557273935, 49 clinicians
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7000

2979 Main St
Bridgeport, CT 06606-4284
Phone (203) 683-5100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10298CTMDSocial Worker
161300CTMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
QMG4, LLC CurrentSince Jul 13, 2022 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Apr 11, 2022 Accepting new patients
QMG3, LLC CurrentSince Jul 13, 2022 Accepting new patients
Hartford Healthcare Urgent Care Centers, LLC CurrentSince Jun 1, 2023 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Apr 11, 2022 Accepting new patients
QMG5,LLC CurrentSince Jul 13, 2022 Accepting new patients
QMG2,LLC CurrentSince Jul 13, 2022 Accepting new patients
Quentin Medical Group, LLC CurrentSince Jul 13, 2022 Accepting new patients
Danbury Hospital Current Accepting new patients
Danbury Hospital CurrentSince Oct 1, 2023 Accepting new patients

Locations

385 W Main St
Avon, CT 06001
Phone (860) 777-1280

161 Boston Ave
Bridgeport, CT 06610
Phone (203) 333-4400

2979 Main St
Bridgeport, CT 06606
Phone (203) 333-8800

4200 Main St
Bridgeport, CT 06606
Phone (203) 916-5151

20 Germantown Rd
Danbury, CT 06810
Phone (203) 739-4820

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

1918 Black Rock Tpke
Fairfield, CT 06825
Phone (203) 583-8400

21 Elm St
New Milford, CT 06776
Phone (860) 210-5000

389 Bridgeport Ave
Shelton, CT 06484
Phone (203) 567-4171

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

57 Monroe Tpke
Trumbull, CT 06611
Phone (203) 675-1345

Organizations & group practices 10

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 2

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": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1699388728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2979 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064284",
            "telephone_number": "036-835-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064284",
            "telephone_number": "036-835-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYKA",
        "first_name": "TRAVIS",
        "credential": "APRN FNP-C CEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-28",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "10298",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CT",
            "license": "161300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.