Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kentrone Vines, AGACNP-BC

Individual provider Acute Care Nurse Practitioner · NPI 1003611013

Kentrone Vines, AGACNP-BC is a Nurse Practitioner in New Haven, Connecticut. Qualified in 2024, 2 years ago. Practices with Northeast Medical Group Inc, a 1,360-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
2
Licensed in
CT
In the registry since
2025

Practice location Address checks out

20 York St
New Haven, CT 06510-3220
Phone: (203) 688-4242
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 14470 (CT)

Record details

NPI number1003611013
Entity typeIndividual (Type 1)
GenderMale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedFebruary 14, 2025
Last updated in NPPESFebruary 14, 2025
Certification dateJanuary 23, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Northeast Medical Group Inc — 1360 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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