Individual provider Active NPI

Mikaylyn Kathleen Peet

  • Family Nurse Practitioner
  • Waterbury, CT
National Provider Identifier
1790649176
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15254 Issued in CT
Practice address
920 Wolcott St
Waterbury, CT 06705-1300
Phone
(860) 650-3848
NPI assigned
Dec 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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 15254 CT Primary

Addresses

Primary practice location

920 Wolcott St
Waterbury, CT 06705-1300

Mailing address

203 N Main St
Thomaston, CT 06787-1624
Phone (203) 592-4226

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260114000328 CT Practitioner - Nurse Practitioner 7719463397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Medical Associates, LLCGroup PAC ID 7214107515, 113 clinicians

Practice addresses (Care Compare)

920 Wolcott St
Suite 19
Waterbury, CT 06705-1300
Phone (860) 650-3848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15254CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Medical Associates, LLC Family CurrentSince Feb 1, 2026 Accepting new patients
WRK Ventures, LLC PastSince Feb 1, 2026 Accepting new patients

Locations

900 Main St S
Ste 100
Southbury, CT 06488
Phone (203) 262-1911

Organizations & group practices 2

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": "1765324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1790649176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N MAIN ST",
            "city": "THOMASTON",
            "state": "CT",
            "postal_code": "067871624",
            "telephone_number": "203-592-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 WOLCOTT ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051300",
            "telephone_number": "860-650-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEET",
        "first_name": "MIKAYLYN",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-10",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "15254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.