Active NPI
Monica Vanessa Carrillo
- Homemaker
- Manchester, CT
National Provider Identifier
1003380874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- License
- HCA.0001219
- Practice address
- 35 Steele Farm Dr
Manchester, CT 06042-8548 - Phone
- (860) 706-3905
- NPI assigned
- Jan 15, 2019
- Last updated
- Jan 15, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | HCA.0001219 | CT | Primary |
Addresses
Primary practice location
35 Steele Farm Dr
Manchester, CT 06042-8548
Mailing address
35 Steele Farm Dr
Manchester, CT 06042-8548
Phone (860) 706-3905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HCA.0001219 | CT | MD | Homemaker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bainca's Senior Care LLC | Homemaker | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1003380874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 STEELE FARM DR",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060428548",
"telephone_number": "860-706-3905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 STEELE FARM DR",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060428548",
"telephone_number": "860-706-3905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRILLO",
"first_name": "MONICA",
"middle_name": "VANESSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-15",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "CT",
"license": "HCA.0001219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.