Individual provider Active NPI

Kristal Velazquez, CNM

  • Midwife
  • Hartford, CT
National Provider Identifier
1841838596
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
461 Issued in CT
Practice address
21 Grand St
Hartford, CT 06106-1541
Phone
(860) 550-7500
NPI assigned
Dec 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 461 CT Primary

Addresses

Primary practice location

21 Grand St
Hartford, CT 06106-1541

Mailing address

60 Norwood Ave
Hamden, CT 06518-2606
Phone (203) 668-4284

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200116002455 CT Practitioner - Certified Nurse Midwife (CNM) 3072948215 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
461CTMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Charter Oak Health Center, Inc. CurrentSince Dec 18, 2019 Accepting new patients
Charter Oak Health Center, Inc. CurrentSince Dec 18, 2019 Accepting new patients
Fair Haven Community Health Clinic Inc Midwife Past Accepting new patients

Locations

21 Grand St
Hartford, CT 06106

Interoperability endpoints

  • Direct secure messaging: kvelazquez467875@direct.ynhh.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.

NPI Registry JSON

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1841838596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 NORWOOD AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182606",
            "telephone_number": "203-668-4284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GRAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061061541",
            "telephone_number": "860-550-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "KRISTAL",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CT",
            "license": "461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.