NPIMap

Individual provider Active NPI

Peggy Ku, D.O.

  • Obstetrics & Gynecology Physician
  • West Hartford, CT
National Provider Identifier
1700087228
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
045402 Issued in CT
Practice address
345 N Main St
Suite 242
West Hartford, CT 06117-2515
Phone
(860) 231-1644
Fax
(860) 231-8868
NPI assigned
May 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 045402 CT Primary

Addresses

Primary practice location

345 N Main St
Suite 242
West Hartford, CT 06117-2515

Mailing address

345 N Main St
Suite 242
West Hartford, CT 06117-2515
Phone (860) 231-1644

Other identifiers 3

IdentifierTypeStateIssuer
040045402CT01OtherCTANTHEM
045402OtherCTPHYSICIAN LICENSE
001454024MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070720000618 CT Practitioner - Obstetrics/GynecologyPractitioner - Osteopathic Manipulative Medicine 3274634209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Osteopathic Manipulative Medicine
Education
University of New England, College of Osteo Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians for Women'S Health, LLCGroup PAC ID 3274430665, 319 clinicians

Practice addresses (Care Compare)

103 Newtown Rd
Candlewood Center for Womens Health
Danbury, CT 06810-4195
Phone (203) 730-8789

1050 Sullivan Ave
Suite A4
South Windsor, CT 06074-2000
Phone (860) 648-2748

345 N Main St
West Hartford, CT 06117-2508

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
045402CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians for Women'S Health LLC Obstetrics & Gynecology CurrentSince Mar 15, 2017 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Obstetrics & Gynecology CurrentSince Jan 23, 2011 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jan 23, 2011 Accepting new patients

Locations

103 Newtown Rd
Danbury, CT 06810
Phone (203) 730-8789

95 Woodland St
Fl 1
Hartford, CT 06105
Phone (860) 714-7362

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

1050 Sullivan Ave
Ste A4
South Windsor, CT 06074
Phone (860) 648-2748

345 N Main St
Ste 242
West Hartford, CT 06117
Phone (860) 231-1644

Interoperability endpoints

  • Direct secure messaging: peggy.ku.1@10170.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1700087228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 N MAIN ST",
            "address_2": "SUITE 242",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172515",
            "telephone_number": "860-231-1644",
            "fax_number": "860-231-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N MAIN ST",
            "address_2": "SUITE 242",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172515",
            "telephone_number": "860-231-1644",
            "fax_number": "860-231-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KU",
        "first_name": "PEGGY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "045402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "040045402CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "045402",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001454024",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.