NPIMap

Individual provider Active NPI

Vivien A Iloeje, MD

  • Internal Medicine Physician
  • East Hartford, CT
National Provider Identifier
1003878778
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
040458 Issued in CT
Practice address
94 Connecticut Blvd
East Hartford, CT 06108-3013
Phone
(860) 528-1359
Fax
(860) 290-4142
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 040458 CT Primary

Addresses

Primary practice location

94 Connecticut Blvd
East Hartford, CT 06108-3013

Mailing address

94 Connecticut Blvd
East Hartford, CT 06108-3013
Phone (860) 528-1359

Other identifiers 3

IdentifierTypeStateIssuer
458040OtherCTCTC
004236164MedicaidCT
010040458CTOtherCTBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111223000095 CT Practitioner - Internal Medicine 3870769755 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group IncGroup PAC ID 1153573902, 257 clinicians

Practice addresses (Care Compare)

55 Meriden Ave
Suite 1D
Southington, CT 06489-3239
Phone (860) 276-5144

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.48 of 100Reported as apm
Quality
83.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
040458CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Jun 1, 2013 Accepting new patients
Hartford Healthcare Medical Group, Inc Internal Medicine CurrentSince May 1, 2018 Accepting new patients
Community Health Center Inc Internal Medicine CurrentSince Jun 1, 2013 Accepting new patients
Hartford Healthcare Medical Group, Inc Past Accepting new patients

Locations

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: vivien.iloeje@xdr.hhchealthdirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1003878778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 CONNECTICUT BLVD",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083013",
            "telephone_number": "860-528-1359",
            "fax_number": "860-290-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 CONNECTICUT BLVD",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083013",
            "telephone_number": "860-528-1359",
            "fax_number": "860-290-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILOEJE",
        "first_name": "VIVIEN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "040458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CTC",
            "identifier": "458040",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236164",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010040458CT",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

Verify at the official NPI Registry.