Kristin D Mehta, AGPCNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

8730 Issued in CT

Practice address

208 Valley Rd
New Canaan, CT 06840-3812

Phone

(866) 542-4455

NPI assigned

Apr 17, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Kristin D Koser Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Silver Hill Hospital, Inc

  • Psychiatric Hospital
  • New Canaan, CT
  • NPI 1982658035
  NPD

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1760916761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 VALLEY RD",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068403812",
            "telephone_number": "866-542-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 VALLEY RD",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068403812",
            "telephone_number": "866-542-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "KRISTIN",
        "middle_name": "D",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7564",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "8730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760916761",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K400387628",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "KOSER",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Evan Mason, MD
• Alicia Masucci, MD
• Michaela Rose Matos, DMD
• Matrix Personalized Medicine LLC
• Ann Bonner McCarthy, MS CCC-SLP
• Holly Dale Mensching
• Alexandra Minicucci, LCSW
• Diana Mitova, LMSW
• Emma Molloy, LCSW
• Dina Hadley Monroe, RN, FNP STUDENT

• Nurse Practitioner in New Canaan, CT
• Providers in New Canaan, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; 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.

Verify at the official NPI Registry.