KISMATKUMA DETROJA (NPI# 1497774657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497774657 |
| Entity Type | Individual |
| Full Name | KISMATKUMA DETROJA |
| Credential | MD |
| Practice Address |
112 Mansfield Ave Arbor Inpatient Physicians PC Willimantic CT 06226-2041 |
| Mailing Address |
39 Buckland St Apt 121 2 Manchester CT 06042-7700 |
| Practice Telephone | 8604569116 |
| Mailing Telephone | 8606470092 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2008-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 8 WINDWOOD DRIVE | CT | Allopathic & Osteopathic Physicians |
| Y | 208M00000X | Hospitalist | 8 WINDWOOD DRIVE | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001444629 | 05 | |
| CT | BCBS | 010044462CT01 | 01 |
| CT | HMN | 581828 | 01 |
| CT | CHN | 1497774657 | 01 |
| CT | CONNECTICARE | 144462 | 01 |
| CT | CIGNA | 1497774657 | 01 |
| CIGNA | 149777465 | 01 | |
| TRICARE | 207787971 | 01 | |
| TRICARE | 41044914 | 01 | |
| CT | AETNA | 7382858 | 01 |
| AETNA | 7382858 | 01 |
| Street Address |
112 MANSFIELD AVE ARBOR INPATIENT PHYSICIANS PC |
| City | WILLIMANTIC |
| State | CT |
| Zip Code | 06226-2041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962400630 | Robert Joseph Bundy | Internal Medicine | 112 Mansfield Ave, Pulmonary Dept., Hatch Wing, Willimantic, CT 06226-2041 | 2005-07-07 |
| 1033744289 | Lori Bernier | Social Worker | 112 Mansfield Ave, Willimantic, CT 06226-2045 | 2020-03-09 |
| 1720620065 | Alisa B Bray | Nurse Practitioner | 112 Mansfield Ave, Willimantic, CT 06226-2045 | 2019-10-08 |
| 1194387431 | Marissa Clark | Physician Assistant | 112 Mansfield Ave, Willimantic, CT 06226-2040 | 2019-07-08 |
| 1003301136 | Bethany Joy Kennedy | Nurse Practitioner | 112 Mansfield Ave, Willimantic, CT 06226 | 2018-07-01 |
| 1629475371 | Windham Community Memorial Hospital | Nurse Practitioner | 112 Mansfield Ave, Willimantic, CT 06226-2045 | 2014-11-24 |
| 1952708794 | Windham Community Memorial Hospital | Hospitalist | 112 Mansfield Ave, Willimantic, CT 06226-2045 | 2014-11-21 |
| 1174931687 | Melissa Bohan-hallenbeck | Nurse Practitioner | 112 Mansfield Ave, Willimantic, CT 06226-2045 | 2014-07-28 |
| 1689081085 | Prenatal Clinic | General Acute Care Hospital | 112 Mansfield Ave, Willimantic, CT 06226-2045 | 2014-07-17 |
| 1730477761 | Karin E Grann | Registered Nurse | 112 Mansfield Ave, Willimantic, CT 06226-2045 | 2011-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669962163 | Nutmeg Neuropsychology LLC | Psychologist | 322 Main St Ste 2e-1o, Willimantic, CT 06226 | 2018-05-10 |
| 1104344365 | Taylor Girard | Social Worker | 54-56 Boston Post Road, Willimantic, CT 06226 | 2017-09-07 |
| 1194268490 | Donald Diange | Pharmacist | 1391 Main Street, Willimantic, CT 06226 | 2016-11-18 |
| 1386988954 | Gale K Lockland | Psychologist | 112 Mansfield Avenue, Windham Community Memorial Hospital, Willimantic, CT 06226 | 2012-11-20 |
| 1831343060 | Carlita R Baldwin | Counselor | 366 Ash Street, Unit 4, Willimantic, CT 06226 | 2008-11-14 |
| 1023211190 | Joel Lee Reinholtz | Physical Therapy Assistant | 595 Valley Street, Windham, CT 06226 | 2007-06-07 |
| 1265654719 | Mcsweeney Regional Senior Center | Clinic/Center | 47 Crescent St, Willimantic, CT 06226 | 2007-05-03 |
| 1912012964 | John Wescott Stevens | Dentist | 1581 W Main St, Willmantic, CT 06226 | 2006-08-20 |
| 1801802756 | Kathryn Nelson | Family Medicine | 355 High Street, Willimantic, CT 06226 | 2006-07-31 |
| 1710914379 | The Foot Group, LLC | Podiatrist | 162 A Mansfield Ave, Willimantic, CT 06226 | 2006-06-27 |
| Find all providers in zip 06226 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952708794 | Windham Community Memorial Hospital | Hospitalist | 112 Mansfield Ave, Willimantic, CT 06226-2045 | 2014-11-21 |
| 1023191467 | Windham Community Memorial Hospital | Hospitalist | 112 Mansfield Ave, Willimantic, CT 06226-2045 | 2006-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407338882 | Liming Zeng | Hospitalist | 38 Dundee Dr, Cheshire, CT 06410-1574 | 2018-09-03 |
| 1598171944 | Rabia Rizwan | Hospitalist | 224 Indian Ave, Bridgeport, CT 06606-4843 | 2014-07-07 |
| 1316273485 | Jennifer Brook | Hospitalist | 20 York Street (cb-2041), New Haven, CT 06510 | 2009-10-26 |
| 1124181904 | Keith Swan | Hospitalist | 20 York St # 2041, Ynh Medical Services PC, New Haven, CT 06504-8900 | 2006-12-19 |
| 1558306340 | Anna Rodonski | Hospitalist | 20 York Steet, Cb-2041, New Haven, CT 06510 | 2006-06-17 |
| 1528016755 | Linda M. Hricz-borges | Hospitalist | 20 York Stree, Cb-2041, New Haven, CT 06510 | 2006-05-04 |
| 1346233079 | Wilton Medical Associates PC | Hospitalist | 20 Old Ridgefield Rd, Wilton, CT 06897-3012 | 2005-08-29 |
| 1295218733 | Alexis Laurie Volpe | Hospitalist | 24 Hospital Ave, Danbury, CT 06810 | 2018-09-11 |
| 1992287932 | Nicholas Horvath | Hospitalist | 24 Hospital Ave, Danbury, CT 06810 | 2018-09-06 |
| 1457833907 | Zoe Krause | Hospitalist | 24 Hospital Ave, Danbury, CT 06810-6077 | 2018-08-31 |
| Find all providers with the same taxonomy | ||||
| City | WILLIMANTIC |
| Zip Code | 06226 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.