Individual provider Active NPI

Oleh Kusen, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Old Saybrook, CT
National Provider Identifier
1952684938
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4750 Issued in CT
Practice address
20 Research Pkwy
Old Saybrook, CT 06475-4214
Phone
(800) 370-3651
Fax
(860) 510-0020
NPI assigned
Sep 26, 2011
Last updated
Sep 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4750 CT Primary

Addresses

Primary practice location

20 Research Pkwy
Old Saybrook, CT 06475-4214

Mailing address

20 Research Pkwy
Old Saybrook, CT 06475-4214
Phone (800) 370-3651

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
I20111020000255 CT Practitioner - Nurse Practitioner 9133391964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
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

22 Simsbury Rd
West Hartford, CT 06117-1444
Phone (860) 523-9899

281 Western Blvd
Glastonbury, CT 06033-4386
Phone (860) 430-4247

705 New Britain Ave
Hartford, CT 06106-4039
Phone (860) 527-9126

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Harvest Healthcare LLC CurrentSince Feb 6, 2012 Accepting new patients
Behavioral Wellness Associates, LLC Psychiatric/Mental Health PastSince Apr 1, 2015 Accepting new patients
Cycare LLC PastSince Jun 1, 2016 Accepting new patients

Locations

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

Organizations & group practices 3

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": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1952684938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 RESEARCH PKWY",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754214",
            "telephone_number": "800-370-3651",
            "fax_number": "860-510-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 RESEARCH PKWY",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754214",
            "telephone_number": "800-370-3651",
            "fax_number": "860-510-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSEN",
        "first_name": "OLEH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-26",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "4750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Saybrook, CT

Sources for this page

Verify at the official NPI Registry.