HARTFORD HEALTHCARE MEDICAL GROUP SPECIALISTS LLC (NPI# 1750934048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750934048 |
| Entity Type | Organization |
| Organization Name | HARTFORD HEALTHCARE MEDICAL GROUP SPECIALISTS LLC |
| Practice Address |
85 Seymour St Ste 409 Hartford CT 06106-5523 |
| Mailing Address |
1290 Silas Deane Hwy Wethersfield CT 06109-4337 |
| Practice Telephone | 8605470616 |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |
| Authorized Official Name | MARK BANCROFT VYE (VP, ADMINISTRATION) |
| Authorized Official Telephone | 8609727858 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008085761 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295367068 | Hartford Healthcare Medical Group Specialists LLC | Durable Medical Equipment & Medical Supplies | 85 Poheganut Drive, Suite 3, Groton, CT 06340-3252 | 2020-02-10 |
| 1790338978 | Hartford Healthcare Medical Group Specialists LLC | Durable Medical Equipment & Medical Supplies | 455 Lewis Ave Ste 210, Meriden, CT 06451-2121 | 2019-07-17 |
| 1205489465 | Hartford Healthcare Medical Group Specialists LLC | Durable Medical Equipment & Medical Supplies | 100 Hazard Ave Ste 206, Enfield, CT 06082-5447 | 2019-07-17 |
| 1629621891 | Hartford Healthcare Medical Group Specialists LLC | Durable Medical Equipment & Medical Supplies | 65 Memorial Rd Ste 430, West Hartford, CT 06107-4220 | 2019-07-17 |
| 1750934998 | Hartford Healthcare Medical Group Specialists LLC | Durable Medical Equipment & Medical Supplies | 330 Western Blvd, Glastonbury, CT 06033-4383 | 2019-07-17 |
| 1023584216 | Hartford Healthcare Medical Group Specialists LLC | Transplant Surgery | 85 Seymour St Ste 415, Hartford, CT 06106-5523 | 2018-10-16 |
| Street Address |
85 SEYMOUR ST STE 409 |
| City | HARTFORD |
| State | CT |
| Zip Code | 06106-5523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558429944 | Jean B Stielau | Nurse Practitioner | 85 Seymour St Ste 409, Hartford, CT 06106-5523 | 2006-12-05 |
| 1366008963 | Marie Sanzo | Nurse Practitioner | 85 Seymour St Ste 409, Hartford, CT 06106-5523 | 2019-05-20 |
| 1548608219 | Ali Irshad | Surgery | 85 Seymour St Ste 409, Hartford, CT 06106-5523 | 2013-06-04 |
| 1942515408 | Edward Dewitt Gifford | Surgery | 85 Seymour St Ste 409, Hartford, CT 06106-5523 | 2010-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750907325 | Vartika Kesarwani | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care-brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-19 |
| 1720602865 | Meher Kaur Singha | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care- Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-04 |
| 1497314140 | Eduardo Mantovani Cardoso | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adut Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-06-06 |
| 1114582178 | Dimitrios Drekolias | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-05-06 |
| 1316501687 | Rafae Shaikh | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-04-23 |
| 1437643715 | Lucas Bensa | Social Worker | 421 Washington St., Apt C1, Hartford, CT 06106 | 2018-06-19 |
| 1548754310 | Collin Dimler | Physician Assistant | 85 Seymour St Ste 1003, Hartford, CT 06106 | 2018-06-15 |
| 1619460581 | Bryan F Stringer | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave., Hh-adult Primary Care - Brown Stone, Hartford, CT 06106 | 2018-06-14 |
| 1083103972 | Margret Sigurdardottir Blondal | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Ste 4h, Hartford, CT 06106 | 2018-05-07 |
| 1265920995 | Rudra Ramanathan | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave Brown Stone, Hartford, CT 06106 | 2018-04-27 |
| Find all providers in zip 06106 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801405485 | Hanger Medical | Durable Medical Equipment & Medical Supplies | 100 Retreat Ave Ste 800, Hartford, CT 06106-2528 | 2020-07-29 |
| 1083233779 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 331 Wethersfield Ave Rm 149, Hartford, CT 06114-1420 | 2020-04-13 |
| 1689184350 | Jamaro Edwards | Durable Medical Equipment & Medical Supplies | 1465 Albany Ave, Hartford, CT 06112-2110 | 2017-10-06 |
| 1962928093 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 56 Coventry St Ste B, Hartford, CT 06112-1524 | 2017-08-21 |
| 1740727577 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 45 Wadsworth St Ste P, Hartford, CT 06106-7108 | 2017-01-31 |
| 1952646739 | Hartford Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 469 Park St, Hartford, CT 06106-1519 | 2012-12-04 |
| 1417243452 | Lcse Services LLC | Durable Medical Equipment & Medical Supplies | 241 Asylum St, Hartford, CT 06103-1515 | 2011-06-28 |
| 1528367182 | Freds Stores of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 1135 Us Highway 231 S., Hartford, KY 42347-1872 | 2011-03-22 |
| 1073715140 | Arrow Prescription Center #12 | Durable Medical Equipment & Medical Supplies | 100 Woodland Street, Hartford, CT 06105 | 2007-06-01 |
| 1750592564 | Avon Medical Pharmacy | Durable Medical Equipment & Medical Supplies | Arrow Prescription Center 11, 500 Albany Avenue, Hartford, CT 06120 | 2007-05-24 |
| Find all providers in HARTFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.