Stephen Kivlin, NP-C
Individual provider Active NPI Family Nurse Practitioner · Marlborough, CT
NPI 1982172771 · NPPES record last updated Nov 16, 2018
Key facts
- NPI
- 1982172771
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 7965 (CT)
- Practice address
- 14 Jones Hollow Rd
Marlborough, CT 06447-1448 - Phone
- (860) 295-8217
- NPI assigned
- Nov 9, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Prohealth Physicians PC
Practice addresses (Care Compare)
14 Jones Hollow Rd
Marlborough, CT 06447-1448
Phone (860) 295-8217
Hospital & facility affiliations
- Middlesex Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190111000575 | CT | Practitioner - Nurse Practitioner | 7517203565 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Physicians PC | Family | Current |
Accepting new patients |
Locations
3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200
14 Jones Hollow Rd
Marlborough, CT 06447
Phone (860) 295-8217
115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810
Interoperability endpoints
- stephen.kivlin.npi1982172771.phpct@direct.optumcare.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 7965 | CT | Yes |
Addresses
Primary practice location
14 Jones Hollow Rd
Marlborough, CT 06447-1448
Mailing address
14 Jones Hollow Rd
Marlborough, CT 06447-1448
Other providers in Marlborough, CT
- Drew Hunter
- Inclined Mobility
- Stuart L. Jablon
- Kellie Coleman DC LLC
- Shelly L Kennedy
- Keira Nicole Kopchyak
- Annie-Karine Lamoureux
- Lawrence P. Ryan, DDS, MD, PC
- Matthew C. Lee
- Joan Cost Lester
All providers in Marlborough, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.