Individual provider Active NPI

Kathryn Fletcher, M.D.

  • Neonatal-Perinatal Medicine Physician
  • New Haven, CT
National Provider Identifier
1952661936
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
68691 Issued in CT
Practice address
430 Congress Ave FL 1
New Haven, CT 06519-1313
Phone
(203) 688-2320
NPI assigned
May 23, 2012
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 036145995 IL
Neonatal-Perinatal Medicine Physician 2080N0001X A137437 CA
Neonatal-Perinatal Medicine Physician 2080N0001X 68691 CT Primary

Addresses

Primary practice location

430 Congress Ave FL 1
New Haven, CT 06519-1313

Mailing address

430 Congress Ave FL 1
New Haven, CT 06519-1313
Phone (203) 688-2320

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
I20210913002942 CT Practitioner - Pediatric Medicine 5395141519 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A137437CAMDNeonatal-Perinatal Medicine Physician
68691CTMDNeonatal-Perinatal Medicine Physician
036145995ILMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Aug 26, 2021 Accepting new patients
Yale University Current Accepting new patients
Yale University CurrentSince Aug 26, 2021 Accepting new patients
Renaissance Medical Group Past Accepting new patients

Locations

430 Congress Ave
Fl 1
New Haven, CT 06519
Phone (203) 688-2320

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

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

1 Park St
North Haven, CT 06504
Phone (203) 785-2701

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": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1952661936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 CONGRESS AVE FL 1",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191313",
            "telephone_number": "203-688-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 CONGRESS AVE FL 1",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191313",
            "telephone_number": "203-688-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "KATHRYN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IL",
            "license": "036145995",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A137437",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CT",
            "license": "68691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.