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

Keri Wieczerzak

Individual provider Medical Physician Assistant · NPI 1790314565

Keri Wieczerzak is a Physician Assistant in Hartford, Connecticut. Qualified in 2021, 5 years ago. Practices with Hartford Hospital, a 1,040-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

80 Jefferson St
Hartford, CT 06106-5035
Phone: (860) 972-5022
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 365 Montauk Ave, New London, CT 06320-4700 — (860) 442-0711

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1790314565
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 3, 2020
Last updated in NPPESMay 6, 2024
Certification dateMay 6, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Hartford Hospital — 1040 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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