4 ELEMENTS DIRECT PRIMARY CARE LLC
NPI 1730756636
Internal Medicine in South Windsor, CT

Active since June 08, 2021CLIA Certified · 2 labs
1300 SULLIVAN AVE, SOUTH WINDSOR, CT 06074(860) 469-5646(860) 310-1122 Get Directions Write a Review

NPPES record last updated: November 1, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About 4 Elements Direct Primary Care Llc NPPES

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

4 ELEMENTS DIRECT PRIMARY CARE LLC (NPI 1730756636) is a healthcare organization registered as an internal medicine in South Windsor, Connecticut and active in the NPI registry since June 2021. The organization holds 2 active CLIA laboratory certificates and lists Vasanth Kainkaryam, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1730756636
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business Name4 ELEMENTS DIRECT PRIMARY CARE LLC
Location Address1300 SULLIVAN AVESouth Windsor, CT 06074-2713
Mailing Address1300 Sullivan AveSouth Windsor, CT 06074-2713 · (860) 469-5646 · Fax (860) 310-1122
Fax(860) 310-1122
Organization SubpartNo
Authorized OfficialVasanth KainkaryamManaging Member · (860) 469-5656
Enumeration DateJune 8, 2021
Last NPPES UpdateNovember 1, 2025
NPPES CertifiedNovember 1, 2025
NPI 1730756636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedPediatricsTaxonomy 208000000X
Also ListedPreventive Medicine · Obesity MedicineTaxonomy 2083B0002X
1300 SULLIVAN AVE, South Windsor, CT 06074

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D2175270

4 Elements Direct Primary Care LLC · South Windsor, CT
Active · expires Nov 18, 2027
CLIA Number07D2175270
Laboratory TypePhysician Office
Certificate Effective DateNovember 19, 2025
Certificate Expiration DateNovember 18, 2027
Laboratory DirectorVasanth Kainkaryam
Laboratory Phone(860) 469-5646
Laboratory Location4 Elements Direct Primary Care LLC1300 Sullivan Ave, South Windsor, CT 06074
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 07D2184255

4 Elements Direct Primary Care LLC · Rocky Hill, CT
Active · expires May 17, 2028
CLIA Number07D2184255
Laboratory TypePhysician Office
Certificate Effective DateMay 18, 2026
Certificate Expiration DateMay 17, 2028
Laboratory DirectorVasanth S. Kainkaryam
Laboratory Phone(860) 469-5646
Laboratory Location4 Elements Direct Primary Care LLC1111 Cromwell Ave, Suite 304, Rocky Hill, CT 06067
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Internal Medicine
1300 SULLIVAN AVE
SOUTH WINDSOR, CT 06074

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1730756636, enumerated as an "organization" on June 08, 2021.

The provider is located at 1300 SULLIVAN AVE SOUTH WINDSOR, CT 06074 and the phone number is (860) 469-5646.

Internal Medicine with taxonomy code 207R00000X.