Individual provider Active NPI

Karen Marie Wunderlich, NP

  • Obstetrics & Gynecology Nurse Practitioner
  • New Milford, CT
National Provider Identifier
1710963483
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
F360330 Issued in NY
Practice address
120 Park Lane Rd Ste B202
New Milford, CT 06776-2450
Phone
(860) 210-0082
Fax
(860) 210-1633
NPI assigned
Dec 15, 2005
Last updated
Feb 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X F360330 NY Primary

Addresses

Primary practice location

120 Park Lane Rd Ste B202
New Milford, CT 06776-2450

Mailing address

120 Park Lane Rd Ste B202
New Milford, CT 06776-2450
Phone (860) 210-0082

Other names 1

  • Karen Marie Stoltz Former name

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
I20130103000018 CT Practitioner - Nurse Practitioner 1557379575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
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

120 Park Lane Rd
Suite B202
New Milford, CT 06776-2450
Phone (860) 210-0082

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.08 of 100Reported as group
Quality
85.82
Promoting interoperability
100
Improvement activities
40
Cost
77.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3584CTMDSocial Worker
F360330NYMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians for Women's Health LLC Obstetrics & Gynecology CurrentSince Sep 10, 2012 Accepting new patients

Locations

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

120 Park Lane Rd
Ste B202
New Milford, CT 06776
Phone (860) 210-0082

780 Litchfield St
Ste 2
Torrington, CT 06790

Interoperability endpoints

  • Direct secure messaging: karen.wunderlich.1@10170.direct.athenahealth.com

Organizations & group practices 1

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1710963483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PARK LANE RD STE B202",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067762450",
            "telephone_number": "860-210-0082",
            "fax_number": "860-210-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PARK LANE RD STE B202",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067762450",
            "telephone_number": "860-210-0082",
            "fax_number": "860-210-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERLICH",
        "first_name": "KAREN",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "F360330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "STOLTZ",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Milford, CT

Sources for this page

Verify at the official NPI Registry.