Individual provider Active NPI

Kimberly M Hudson, APRN

  • Nurse Practitioner
  • Middletown, CT
National Provider Identifier
1790899789
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
002729 Issued in CT
Practice address
420 Saybrook Rd
Middlesex Cardiology Associates
Middletown, CT 06457-4747
Phone
(860) 347-4258
Fax
(860) 704-5924
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 002729 CT Primary

Addresses

Primary practice location

420 Saybrook Rd
Middlesex Cardiology Associates
Middletown, CT 06457-4747

Mailing address

420 Saybrook Rd
Ste a
Middletown, CT 06457-4747
Phone (860) 636-2010

Other identifiers 6

IdentifierTypeStateIssuer
009225787MedicaidCT
2V4899OtherHEALTH NET
P3231049OtherOXFORD
00422578700OtherBDS BLUE CARE
400002729CTOtherANTHEM
027290OtherCT

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
I20050921000600 CT Practitioner - Nurse Practitioner 7214961002 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

420 Saybrook Rd
Middletown, CT 06457-4747
Phone (860) 636-2010

Hospital & facility affiliations

  • Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
002729CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jan 1, 2020 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC Nurse Practitioner CurrentSince Jan 1, 2020 Accepting new patients
Hartford Healthcare Medical Group, Inc Nurse Practitioner CurrentSince Mar 1, 2019 Accepting new patients

Locations

14 Jones Hollow Rd
Marlborough, CT 06447
Phone (860) 295-8217

420 Saybrook Rd
Middletown, CT 06457
Phone (860) 347-4258

420 Saybrook Rd
Ste A
Middletown, CT 06457
Phone (860) 347-4258

51 Main St
Old Saybrook, CT 06475
Phone (860) 388-3564

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

Interoperability endpoints

  • Direct secure messaging: kimberly.hudson@xdr.hhchealthdirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1790899789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SAYBROOK RD",
            "address_2": "STE A",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574747",
            "telephone_number": "860-636-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 SAYBROOK RD",
            "address_2": "MIDDLESEX CARDIOLOGY ASSOCIATES",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574747",
            "telephone_number": "860-347-4258",
            "fax_number": "860-704-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "002729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009225787",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2V4899",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3231049",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BDS BLUE CARE",
            "identifier": "00422578700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "400002729CT",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT",
            "identifier": "027290",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.