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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: August 16, 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
Phone(860) 469-5646
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
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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 NPPES

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

DR. VASANTH KAINKARYAM MD
Internal Medicine
1300 SULLIVAN AVE
SOUTH WINDSOR, CT 06074
Capitol Planning Region (860) 469-5646

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 4 Elements Direct Primary Care LLC's NPI number?

The NPI number for 4 Elements Direct Primary Care LLC is 1730756636. It was assigned to this organization in the NPPES registry on June 8, 2021.

Where is 4 Elements Direct Primary Care LLC located?

4 Elements Direct Primary Care LLC is located at 1300 Sullivan Ave, South Windsor, CT 06074. The listed phone number is (860) 469-5646.

What is 4 Elements Direct Primary Care LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does 4 Elements Direct Primary Care LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for 4 Elements Direct Primary Care LLC was last updated on November 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.