Individual provider Active NPI

Kurt R Stewart, M.D.

  • Pediatrics Physician
  • South Windsor, CT
National Provider Identifier
1942211420
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
041441 Issued in CT
Practice address
15 Morgan Farms Dr
South Windsor, CT 06074-1372
Phone
(860) 644-5458
Fax
(860) 644-5687
NPI assigned
Aug 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 041441 CT Primary

Addresses

Primary practice location

15 Morgan Farms Dr
South Windsor, CT 06074-1372

Mailing address

4 Farm Springs Rd
Prohealth Physicians
Farmington, CT 06032-2573
Phone (860) 284-5200

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
I20041123000675 CT Practitioner - Pediatric Medicine 6103881735 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
041441CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Pediatrics CurrentSince Mar 29, 2010 Accepting new patients

Locations

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

4 Farm Springs Rd
Farmington, CT 06032
Phone (860) 284-5200

15 Morgan Farms Dr
South Windsor, CT 06074
Phone (860) 644-2006

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

Interoperability endpoints

  • Direct secure messaging: kurt.stewart.npi1942211420.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, 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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942211420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FARM SPRINGS RD",
            "address_2": "PROHEALTH PHYSICIANS",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322573",
            "telephone_number": "860-284-5200",
            "fax_number": "860-284-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MORGAN FARMS DR",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060741372",
            "telephone_number": "860-644-5458",
            "fax_number": "860-644-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "KURT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "041441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Windsor, CT

Sources for this page

Verify at the official NPI Registry.