Active NPI
Tess Kryspin Lombard, MD
- Internal Medicine Physician
- Waterbury, CT
National Provider Identifier
1710999198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 035945
- Practice address
- 80 Phoenix Ave
Waterbury, CT 06702-1418 - Phone
- (203) 756-8021
- Fax
- (203) 573-5832
- NPI assigned
- Aug 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 035945 | CT | Primary |
Addresses
Primary practice location
80 Phoenix Ave
Waterbury, CT 06702-1418
Mailing address
80 Phoenix Ave
Ste 201
Waterbury, CT 06702-1418
Phone (203) 756-8021
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TIN | Other | NORTHEAST HEALTH DIRECT | |
| P00220769 | Other | CT | RAILROAD MEDICARE |
| P340749 | Other | CT | OXFORD HEALTH PLANS |
| TIN | Other | FOCUS | |
| TIN | Other | NATIONAL PROVIDER NETWORK | |
| 9037810 | Other | CT | CIGNA |
| TIN | Other | PIONEER | |
| TIN | Other | GREAT WEST | |
| TIN | Other | FIRST HEALTH/ CCN | |
| TIN | Other | MULTIPLAN | |
| 5695R1 | Other | CT | EMPIRE BC/BS |
| TIN | Other | POMCO | |
| 010035945CT03 | Other | CT | ANTHEM BC/BS |
| 035945 | Other | CT | CONNECTICARE |
| 2V5273 | Other | CT | HEALTH NET |
| 3990545 | Other | CT | AETNA |
| TIN | Other | NEHCA HMC/PPO |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- New York Medical College, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
80 Phoenix Ave
Waterbury, CT 06702-1418
Phone (203) 757-5491
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 035945 | CT | MD | Internal Medicine Physician |
Interoperability endpoints
- tess.kryspin@fchc1.eclinicaldirectplus.com
Ownership & related parties
All facility ownership & control disclosures 2
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Staywell Health Center | Federally qualified health center | Corporate Officer Corporate Director W-2 Managing Employee |
May 5, 2017 May 5, 2017 May 5, 2017 |
| Staywell Health Center | Federally qualified health center | Corporate Director W-2 Managing Employee |
May 5, 2017 May 5, 2017 |
Owned or controlled facilities with NPI records 2
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Family Medicine Physician
- Waterbury, CT
- NPI 1154342335
Corporate Director, Corporate Officer, W-2 Managing Employee
-
- Family Medicine Physician
- Waterbury, CT
- NPI 1932355567
Corporate Director, W-2 Managing Employee
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Waterbury, CT
- NPI 1154342335
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Waterbury, CT
- NPI 1477902641
-
- General Acute Care Hospital
- Waterbury, CT
- NPI 1760426969
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516060800000",
"number": "1710999198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 PHOENIX AVE",
"address_2": "STE 201",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067021418",
"telephone_number": "203-756-8021",
"fax_number": "203-596-3085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 PHOENIX AVE",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067021418",
"telephone_number": "203-756-8021",
"fax_number": "203-573-5832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOMBARD",
"first_name": "TESS",
"middle_name": "KRYSPIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-13",
"last_updated": "2018-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "035945",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTHEAST HEALTH DIRECT",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00220769",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLANS",
"identifier": "P340749",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FOCUS",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL PROVIDER NETWORK",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "9037810",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PIONEER",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH/ CCN",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC/BS",
"identifier": "5695R1",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "POMCO",
"identifier": "TIN",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "010035945CT03",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "035945",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "2V5273",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3990545",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEHCA HMC/PPO",
"identifier": "TIN",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.