Individual provider Active NPI

Diane Cichy, AG-ACNP

  • Critical Care Medicine Nurse Practitioner
  • Avon, CT
National Provider Identifier
1871040287
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
006575 Issued in CT
Practice address
20 W Avon Rd Ste 202
Avon, CT 06001-3677
Phone
(860) 866-8982
NPI assigned
Sep 1, 2016
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 6575 CT
Critical Care Medicine Nurse Practitioner 363LC0200X 006575 CT Primary

Addresses

Primary practice location

20 W Avon Rd Ste 202
Avon, CT 06001-3677

Mailing address

20 W Avon Rd Ste 202
Avon, CT 06001-3677
Phone (860) 966-0070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6575CTMDGeneral Practice Dentistry
006575CTMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Sep 16, 2016 Accepting new patients
University of Connecticut Health Center CurrentSince Sep 16, 2016 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Nov 10, 2023 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

175 Capital Blvd
Fl 4
Rocky Hill, CT 06067
Phone (860) 380-0452

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: dcichy10691@direct.med.uchc.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1871040287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W AVON RD STE 202",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013677",
            "telephone_number": "860-966-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W AVON RD STE 202",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013677",
            "telephone_number": "860-866-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICHY",
        "first_name": "DIANE",
        "credential": "AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "6575",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "CT",
            "license": "006575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.