Active NPI
Magdalena Kazmierczak, M.D.
- Pediatric Emergency Medicine (Pediatrics) Physician
- Waterbury, CT
National Provider Identifier
1740696293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Emergency Medicine (Pediatrics) Physician
- License
- 64262
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT207504 | PA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America LLC | Current | Accepting new patients | |
| Cep America LLC | Current | Accepting new patients | |
| Trinity Health of New England Provider Network Organization Inc | Current | Accepting new patients | |
| Trinity Health of New England Provider Network Organization Inc | Current | Accepting new patients | |
| Cep America LLC | Current | 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
- 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.
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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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.