Individual provider Active NPI

Kristen Marie Direnzo, FNP

  • Family Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1770953069
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN272613 Issued in MA
Practice address
366 Shrewsbury St
Worcester, MA 01604-4647
Phone
(508) 595-2700
Fax
(774) 221-5136
NPI assigned
Sep 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN272613 MA Primary

Addresses

Primary practice location

366 Shrewsbury St
Worcester, MA 01604-4647

Mailing address

630 Plantation St FL Street12
Worcester, MA 01605-2038
Phone (508) 595-2700

Other names 1

  • Kristen Marie Layte Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160104000234 MA Practitioner - Nurse Practitioner 3274835640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

366 Shrewsbury St
Worcester, MA 01604-4647
Phone (508) 595-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc CurrentSince Sep 5, 2017 Accepting new patients

Locations

460 Southbridge St
Auburn, MA 01501
Phone (508) 595-2700

900 Union St
Westborough, MA 01581
Phone (508) 871-0700

630 Plantation St
#12
Worcester, MA 01605

366 Shrewsbury St
Worcester, MA 01604
Phone (508) 595-2700

5 Neponset St
Fl 12
Worcester, MA 01606
Phone (508) 852-6175

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

Interoperability endpoints

  • Direct secure messaging: kristen.direnzo.npi1770953069.reliant@direct.optumcare.masshiway.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1770953069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST FL STREET12",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052038",
            "telephone_number": "508-595-2700",
            "fax_number": "774-221-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 SHREWSBURY ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016044647",
            "telephone_number": "508-595-2700",
            "fax_number": "774-221-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRENZO",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN272613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "LAYTE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.