Individual provider Active NPI

Kimberly Hayden Miles, APRN

  • Family Nurse Practitioner
  • Wallingford, CT
National Provider Identifier
1851750459
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6462 Issued in CT
Practice address
950 Yale Ave
Wallingford, CT 06492-1858
Phone
(203) 265-9600
NPI assigned
Feb 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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 6462 CT Primary

Addresses

Primary practice location

950 Yale Ave
Wallingford, CT 06492-1858

Mailing address

950 Yale Ave
Wallingford, CT 06492-1858
Phone (203) 265-9600

Other names 1

  • Kimberly Hayden Leahy Former name

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
I20160505001811 CT Practitioner - Nurse Practitioner 4880993211 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
Telehealth
Offers telehealth services
Group practices
Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians

Practice addresses (Care Compare)

950 Yale Ave
Wallingford, CT 06492-1858
Phone (203) 269-3170

Hospital & facility affiliations

  • Masonicare Home Health & Hospice, Inc Home health agency, Wallingford, CT, CCN 077159
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Midstate Medical Center Hospital, Meriden, CT, CCN 070017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6462CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Family CurrentSince Mar 7, 2016 Accepting new patients

Locations

105 Newtown Rd
Ste 1A
Danbury, CT 06810
Phone (203) 790-4511

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

950 Yale Ave
Wallingford, CT 06492
Phone (203) 265-9600

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: kimberly.miles.npi1851750459.phpct@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.

Hospital & facility affiliations 5

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": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1851750459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 YALE AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921858",
            "telephone_number": "203-265-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 YALE AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921858",
            "telephone_number": "203-265-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "KIMBERLY",
        "middle_name": "HAYDEN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-11",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "LEAHY",
            "middle_name": "HAYDEN",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.