Individual provider Active NPI

Serena Klein, APRN

  • Nurse Practitioner
  • Shelton, CT
National Provider Identifier
1881165744
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7954 Issued in CT
Practice address
172 Rocky Rest Rd
Shelton, CT 06484-4234
Phone
(203) 281-3500
NPI assigned
Dec 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7954 CT
Nurse Practitioner 363L00000X 7954 CT Primary

Addresses

Primary practice location

172 Rocky Rest Rd
Shelton, CT 06484-4234

Mailing address

147 Cricket LN
Orange, CT 06477-2646
Phone (203) 430-7389

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
I20190124001515 CT Practitioner - Nurse Practitioner 2567709868 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvest Healthcare LLCGroup PAC ID 9931276979, 72 clinicians

Practice addresses (Care Compare)

21 Waterville Rd
Avon, CT 06001-2097
Phone (860) 284-0182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7954CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harvest Healthcare LLC Nurse Practitioner CurrentSince Jul 22, 2024 Accepting new patients
Alignmed Partners, PC CurrentSince Dec 1, 2018 Accepting new patients

Locations

21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182

850 Mix Ave
Hamden, CT 06514
Phone (203) 281-3500

172 Rocky Rest Rd
Shelton, CT 06484
Phone (203) 924-6268

1 Emerson Dr
Windsor, CT 06095
Phone (860) 688-6443

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": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1881165744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 CRICKET LN",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064772646",
            "telephone_number": "203-430-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 ROCKY REST RD",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844234",
            "telephone_number": "203-281-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "SERENA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "7954",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "7954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

Verify at the official NPI Registry.