Individual provider Active NPI

Elise Winter, PA-C

  • Physician Assistant
  • Vernon, CT
National Provider Identifier
1003195785
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002622 Issued in CT
Practice address
520 Hartford Tpke
Suite M
Vernon, CT 06066-5037
Phone
(860) 872-8321
Fax
(860) 875-6271
NPI assigned
Aug 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X CT
Physician Assistant 363A00000X 002622 CT Primary
Family Medicine Physician 207Q00000X 002622 CT

Addresses

Primary practice location

520 Hartford Tpke
Suite M
Vernon, CT 06066-5037

Mailing address

520 Hartford Tpke
Suite M
Vernon, CT 06066-5037
Phone (860) 872-8321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110916000231 CT Practitioner - Physician Assistant 0042481327 Reassigns benefits to 2 organizations
I20220603000609 MA Practitioner - Physician Assistant 0042481327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Urgent Care Centers LLCGroup PAC ID 7618242777, 201 clinicians
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

1315 Main St
Suite 3
Willimantic, CT 06226-1931
Phone (860) 576-8771

1646 Boston Post Rd
Milford, CT 06460-2776
Phone (203) 706-4219

35 Talcottville Rd
Vernon, CT 06066-5261
Phone (860) 787-5774

366 Shrewsbury St
Worcester, MA 01604-4647
Phone (508) 595-2700

385 W Main St
Avon, CT 06001-4357
Phone (860) 777-6977

5 Neponset St
Worcesteer, MA 01606-2714
Phone (508) 595-2300

775 Queen St
Southington, CT 06489-1531
Phone (860) 777-1281

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002622CTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthwise Medical Associates, LLP Family Medicine PastSince Feb 23, 2015 Accepting new patients
Prospect CT Medical Foundation, Inc. Family Medicine PastSince Sep 1, 2018 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: elise.winter@xdr.hhchealthdirect.org
  • Direct secure messaging: elise.winter.npi1003195785.reliant@direct.optumcare.masshiway.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1003195785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 HARTFORD TPKE",
            "address_2": "SUITE M",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060665037",
            "telephone_number": "860-872-8321",
            "fax_number": "860-875-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 HARTFORD TPKE",
            "address_2": "SUITE M",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060665037",
            "telephone_number": "860-872-8321",
            "fax_number": "860-875-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTER",
        "first_name": "ELISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-11",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "002622",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "002622",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, CT

Sources for this page

Verify at the official NPI Registry.