Individual provider Active NPI

Stanley Lorenz Koleszar, RN CRNP

  • Family Nurse Practitioner
  • Putnam, CT
National Provider Identifier
1972571354
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP010390 Issued in PA
Practice address
7 Kennedy Dr
Putnam, CT 06260-1939
Phone
(860) 928-7704
Fax
(860) 928-4092
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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 SP010390 PA Primary

Addresses

Primary practice location

7 Kennedy Dr
Putnam, CT 06260-1939

Mailing address

320 Pomfret Street
CSB 2
Putnam, CT 06260-1836
Phone (860) 928-6541

Other practice location 1

330 Pomfret St
Putnam, CT 06260-3803
Phone (860) 928-7704

Other identifiers 1

IdentifierTypeStateIssuer
167622XZJMedicaidPA

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
I20150323001637 CT Practitioner - Nurse Practitioner 9931126877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Maryland School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Day Kimball Medical Group IncGroup PAC ID 1557514411, 91 clinicians

Practice addresses (Care Compare)

7 Kennedy Dr
Putnam, CT 06260-1939
Phone (860) 928-7704

Hospital & facility affiliations

  • Day Kimball Healthcare Home health agency, North Grosvenordale, CT, CCN 077097
  • Day Kimball Hospital Hospital, Putnam, CT, CCN 070003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
SP010390PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Day Kimball Medical Group Inc CurrentSince Mar 1, 2015 Accepting new patients
Peoples Community Health Center, Inc Past Accepting new patients
Baltimore Medical System, Inc. Past Accepting new patients
Peoples Community Health Center, Inc Past Accepting new patients

Locations

132 Westminster Rd
Canterbury, CT 06331
Phone (860) 546-2225

612 Hartford Pike
Dayville, CT 06241
Phone (860) 779-0284

320 Pomfret St
#2
Putnam, CT 06260

330 Pomfret St
Putnam, CT 06260
Phone (860) 928-2736

7 Kennedy Dr
Putnam, CT 06260
Phone (860) 928-7704

57 Academy Rd
Woodstock, CT 06281
Phone (860) 928-6575

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1694/brand/19/csg/48/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1972571354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 POMFRET STREET",
            "address_2": "CSB 2",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601836",
            "telephone_number": "860-928-6541",
            "fax_number": "860-963-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 KENNEDY DR",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601939",
            "telephone_number": "860-928-7704",
            "fax_number": "860-928-4092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Pomfret St",
            "address_purpose": "LOCATION",
            "city": "Putnam",
            "state": "CT",
            "postal_code": "062603803",
            "country_code": "US",
            "telephone_number": "860-928-7704",
            "fax_number": "860-928-4092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLESZAR",
        "first_name": "STANLEY",
        "middle_name": "LORENZ",
        "credential": "RN CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP010390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167622XZJ",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Putnam, CT

Sources for this page

Verify at the official NPI Registry.