Individual provider Active NPI

Magdalena Kazmierczak, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Waterbury, CT
National Provider Identifier
1740696293
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
64262 Issued in CT
Practice address
56 Franklin St
Waterbury, CT 06706-1253
Phone
(203) 709-3534
NPI assigned
Jul 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT207504 PA
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 64262 CT Primary

Addresses

Primary practice location

56 Franklin St
Waterbury, CT 06706-1253

Mailing address

56 Franklin St Ste 1
Waterbury, CT 06706-1281
Phone (203) 709-3534

Other names 1

  • Magdalena Kazmierczak Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkazmierczak457199@direct.stfranciscare.org Direct

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200708001302 CT Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 7416370507 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT207504PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Apr 7, 2025 Accepting new patients
Cep America LLC Current Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Mar 27, 2022 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Mar 27, 2022 Accepting new patients
Cep America LLC CurrentSince Apr 7, 2025 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

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

56 Franklin St
Ste 1
Waterbury, CT 06706
Phone (203) 709-6479

Interoperability endpoints

  • Direct secure messaging: mkazmierczak2389044@direct.trinity-health.org

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1740696293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST STE 1",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061281",
            "telephone_number": "203-709-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061253",
            "telephone_number": "203-709-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZMIERCZAK",
        "first_name": "MAGDALENA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-05",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT207504",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "CT",
            "license": "64262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkazmierczak457199@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "56 Franklin St",
            "city": "Waterbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "067061253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MAGDALENA",
            "last_name": "KAZMIERCZAK",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.