Individual provider Active NPI

Katie Michelle Seleznev, NP-C

  • Nurse Practitioner
  • Providence, RI
National Provider Identifier
1982123808
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN01682 Issued in RI
Practice address
208 Collyer St
Providence, RI 02904-1560
Phone
(401) 793-2960
NPI assigned
Sep 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN01682 RI Primary

Addresses

Primary practice location

208 Collyer St
Providence, RI 02904-1560

Mailing address

149 Brewster Rd
West Hartford, CT 06117-2102
Phone (860) 559-1633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20240701004008 RI Practitioner - Nurse Practitioner 4587108568 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN01682RIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Miriam Hospital Nurse Practitioner CurrentSince Apr 25, 2024 Accepting new patients
The Miriam Hospital CurrentSince Apr 25, 2024 Accepting new patients

Locations

208 Collyer St
Providence, RI 02904
Phone (401) 421-4200

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

164 Summit Ave
Ste C
Providence, RI 02906
Phone (401) 793-2931

208 Collyer St
Ste 300
Providence, RI 02904
Phone (401) 793-2960

Organizations & group practices 2

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": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505174400000",
    "number": "1982123808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 BREWSTER RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172102",
            "telephone_number": "860-559-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 COLLYER ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041560",
            "telephone_number": "401-793-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELEZNEV",
        "first_name": "KATIE",
        "middle_name": "MICHELLE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2017-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN01682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.