Individual provider Active NPI

Elena Kozlova, D.O.

  • Emergency Medicine Physician
  • Danbury, CT
National Provider Identifier
1992236228
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
64908 Issued in CT
Practice address
24 Hospital Ave
Danbury, CT 06810-6099
Phone
(203) 739-7447
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 64908 CT Primary

Addresses

Primary practice location

24 Hospital Ave
Danbury, CT 06810-6099

Mailing address

24 Hospital Ave
Danbury, CT 06810-6099

Other practice location 1

263 Farmington Ave
Farmington, CT 06032-1956
Phone (203) 739-7447

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL NA

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
I20200611000876 CT Practitioner - Emergency Medicine 0244502391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Danbury HospitalGroup PAC ID 1557273935, 49 clinicians

Practice addresses (Care Compare)

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7000

Hospital & facility affiliations

  • Danbury Hospital Hospital, Danbury, CT, CCN 070033

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Danbury Hospital CurrentSince Jul 1, 2020 Accepting new patients
Danbury Hospital Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Nuvance Health Medical Practice CT, Inc. CurrentSince Sep 1, 2020 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

20 Germantown Rd
Danbury, CT 06810
Phone (203) 739-4820

21 Elm St
New Milford, CT 06776
Phone (860) 210-5000

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1992236228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099",
            "telephone_number": "203-739-7447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060321956",
            "country_code": "US",
            "telephone_number": "203-739-7447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZLOVA",
        "first_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "64908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "24 Hospital Ave",
            "city": "Danbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "068106099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.