Individual provider Active NPI

Kristen Grace Shubert

  • Surgical Physician Assistant
  • Hartford, CT
National Provider Identifier
1730949686
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
6593 Issued in CT
Practice address
80 Seymour St
Hartford, CT 06106-3315
Phone
(860) 545-5000
NPI assigned
Mar 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6593 CT
Surgical Physician Assistant 363AS0400X 6593 CT Primary

Addresses

Primary practice location

80 Seymour St
Hartford, CT 06106-3315

Mailing address

1075 Asylum Ave
Hartford, CT 06105-2455

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
I20240627003501 CT Practitioner - Physician Assistant 9638613979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1075 Asylum Ave
Hartford, CT 06105-2455
Phone (860) 714-4402

114 Woodland St
Hartford, CT 06105-1208

47 Palomba Dr
Enfield, CT 06082-3847
Phone (860) 714-6980

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6593CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Oct 6, 2025 Accepting new patients

Locations

47 Palomba Dr
Ste 201
Enfield, CT 06082
Phone (860) 272-2930

1075 Asylum Ave
Hartford, CT 06105
Phone 86071427505

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

345 N Main St
Ste 112
West Hartford, CT 06117
Phone (860) 236-3000

Interoperability endpoints

  • Direct secure messaging: kshubert4457816@direct.trinity-health.org

Organizations & group practices 2

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 4

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": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1730949686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 ASYLUM AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063315",
            "telephone_number": "860-545-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUBERT",
        "first_name": "KRISTEN",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "6593",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "6593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.