Individual provider Active NPI

Kristen Nwanyanwu, M.D., M.B.A.

  • Ophthalmology Physician
  • New Haven, CT
National Provider Identifier
1881821700
Registry record updated Jul 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
54388 Issued in CT
Practice address
40 Temple St
New Haven, CT 06510-2715
Phone
(203) 785-2020
NPI assigned
Jun 18, 2009
Last updated
Jul 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2015

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT195314 PA
Student in an Organized Health Care Education/Training Program 390200000X 4301097274 MI
Student in an Organized Health Care Education/Training Program 390200000X 036132910 IL
Ophthalmology Physician 207W00000X 036132910 IL
Ophthalmology Physician 207W00000X 54388 CT Primary

Addresses

Primary practice location

40 Temple St
New Haven, CT 06510-2715

Mailing address

227 Church St
Unit 2C
New Haven, CT 06510-1817
Phone (734) 945-6303

Other names 1

  • Kristen M Harris 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150915000766 CT Practitioner - Ophthalmology 3779717657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Perelman School of Med at the University of Pennsylvania, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

111 Goose LN
Guilford, CT 06437-5101
Phone (203) 747-7300

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

40 Temple St
New Haven, CT 06510-2715

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301097274MIMDStudent in an Organized Health Care Education/Training Program
MT195314PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Ophthalmology CurrentSince Aug 1, 2015 Accepting new patients
Yale University CurrentSince Aug 1, 2015 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: knwanyanwu319123@direct.ynhh.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437696000000",
    "number": "1881821700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 CHURCH ST",
            "address_2": "UNIT 2C",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065101817",
            "telephone_number": "734-945-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 TEMPLE ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102715",
            "telephone_number": "203-785-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWANYANWU",
        "first_name": "KRISTEN",
        "credential": "M.D., M.B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2015-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT195314",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301097274",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "036132910",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036132910",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "54388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "HARRIS",
            "middle_name": "M",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.