Keri Wieczerzak

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

80 Jefferson St
Hartford, CT 06106-5035

Phone

(860) 972-5022

NPI assigned

Apr 3, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hartford HospitalGroup PAC ID 2567366016, 1,040 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hartford Hospital Hospital, Hartford, CT, CCN 070025

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Medicare reassignment Care Compare group NPD
• Lawrence and Memorial Hospital, Inc.

  • General Acute Care Hospital
  • New London, CT
  • NPI 1073530879

  Medical

  Medicare reassignment NPD
• Hartford Hospital

  • Surgery Physician
  • Hartford, CT
  • NPI 1407806391
  Medicare reassignment
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1902834880
  NPD
• Lawrence and Memorial Hospital, Inc.

  • Community/Retail Pharmacy
  • New London, CT
  • NPI 1184402331
  NPD
• Silver Spring Health Care Management, Inc.

  • Internal Medicine Physician
  • Westerly, RI
  • NPI 1700249851

  Medical

  NPD
• Silver Spring Health Care Management, Inc.

  • Pediatrics Physician
  • Wakefield, RI
  • NPI 1992224497
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Care Compare affiliation
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1902834880
  Care Compare affiliation

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1790314565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 CHURCH ST",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552745",
            "telephone_number": "973-349-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JEFFERSON ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065035",
            "telephone_number": "860-972-5022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "365 Montauk Ave",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "CT",
            "postal_code": "063204700",
            "country_code": "US",
            "telephone_number": "860-442-0711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIECZERZAK",
        "first_name": "KERI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Elizabeth Whitley, N.P.
• Bethany Teresa Whitney, PHYSICIAN ASSISTANT
• Paige Anita Whittaker, PA
• Dana Lynn Wicks, PA-C
• Kristen Wieber
• Shannon Elizabeth Nicole Wiggins
• Ricardo Wijndal, PT
• Amber Wilcher
• Catherine Clinton Wiley, MD
• James Wiley II, MD

• Surgical Physician Assistant in Hartford, CT
• Providers in Hartford, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.