Individual provider Active NPI

Elena Valentinovna Zhakov, FNP

  • Family Nurse Practitioner
  • Farmington, CT
National Provider Identifier
1881944924
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
005146 Issued in CT
Practice address
263 Farmington Ave
Farmington, CT 06030-3922
Phone
(860) 679-3199
NPI assigned
Sep 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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 005146 CT Primary

Addresses

Primary practice location

263 Farmington Ave
Farmington, CT 06030-3922

Mailing address

2288 Burlin Turnpike
Newington, CT 06111
Phone (860) 757-3575

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ezhakov62805@direct.med.uchc.edu

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
I20130412000339 CT Practitioner - Nurse Practitioner 9638315823 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5146CTMDSocial Worker
005146CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Apr 1, 2023 Accepting new patients
American Current Care PA CurrentSince Aug 26, 2019 Accepting new patients
University of Connecticut Health Center CurrentSince Apr 1, 2023 Accepting new patients
American Current Care P.a. CurrentSince Aug 26, 2019 Accepting new patients
Medcare Express LLC PastSince Feb 18, 2008 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

701 Main St
East Hartford, CT 06108
Phone (860) 289-5561

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

972 W Main St
New Britain, CT 06053
Phone (860) 827-0745

Interoperability endpoints

  • Direct secure messaging: ezhakov62805@direct.med.uchc.edu

Organizations & group practices 6

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": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1881944924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2288 BURLIN TURNPIKE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "06111",
            "telephone_number": "860-757-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060303922",
            "telephone_number": "860-679-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHAKOV",
        "first_name": "ELENA",
        "middle_name": "VALENTINOVNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2023-03-28",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "005146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ezhakov62805@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "263 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060303922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.