HEATHER ELMGREN APRN
NPI 1265001507
Nurse Practitioner - Family in Middletown, CT

Q: What is Heather Elmgren's NPI number?

The NPI number for Heather Elmgren is 1265001507. It was assigned to this individual provider in the NPPES registry on June 22, 2021.

Q: What is Heather Elmgren's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Heather Elmgren was last updated on January 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 22, 2021PECOS EnrolledAccepts Medicare Assignment

87.14/100

CMS Quality Rating

101 CENTERPOINT DR, MIDDLETOWN, CT 06457(888) 888-8888 Get Directions Write a Review

NPPES record last updated: January 29, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 29, 2026, Jan 25, 2023, Aug 24, 2022 and 2 more (5 updates tracked since 2021).

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About Heather Elmgren Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEATHER ELMGREN APRN (NPI 1265001507) is an individual family provider in Middletown, Connecticut, licensed in Connecticut (10854) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1265001507

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameHEATHER ELMGRENCredential: APRN

Location Address101 CENTERPOINT DRMiddletown, CT 06457-7568

Mailing Address101 Centerpoint DrMiddletown, CT 06457-7568

Phone(888) 888-8888

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateJune 22, 2021

Last NPPES UpdateJanuary 29, 20265 updates tracked since enumeration

NPPES CertifiedJanuary 29, 2026

✔ NPI 1265001507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CT · 10854

101 CENTERPOINT DR, Middletown, CT 06457

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Heather Elmgren Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820474430

PECOS Enrollment IDI20221005002828, I20260112001083

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

413 services115 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

245 services107 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.

72 services48 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307

A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.

70 services48 patients

Nursing facility discharge management, more than 30 minutes 99316

Nursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.

31 services29 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

24 services24 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06457 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$93.86 typical visit price

range $60.82 – $183.10

Typical copayment $23.46 (range $15.20 – $45.77)

Most-billed visit code 99203

Established Patient

$106.68 typical visit price

range $19.76 – $149.26

Typical copayment $26.67 (range $4.94 – $37.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.14/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

78.26

Improvement Activities

Cost

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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