Individual provider Active NPI

Marc Andre Paradis, M.D.

  • Anesthesiology Physician
  • East Hartford, CT
National Provider Identifier
1003886185
Registry record updated Apr 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
032335 Issued in CT
Practice address
111 Founders PLZ
#300 C/O Ipms
East Hartford, CT 06108-3212
Phone
(860) 282-4137
Fax
(860) 282-0170
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 032335 CT Primary

Addresses

Primary practice location

111 Founders PLZ
#300 C/O Ipms
East Hartford, CT 06108-3212

Mailing address

99 East River Drive
5TH Floor
East Hartford, CT 06108-3212
Phone (860) 282-0833

Other practice location 1

263 Farmington Ave
Farmington, CT 06032-1956
Phone (860) 679-2000

Other identifiers 1

IdentifierTypeStateIssuer
001323352MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mparadis11681@direct.med.uchc.edu Health Information Exchange (HIE)

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
032335CTMDAnesthesiology Physician

Interoperability endpoints

  • Direct secure messaging: mparadis11681@direct.med.uchc.edu

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618617600000",
    "number": "1003886185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 EAST RIVER DRIVE",
            "address_2": "5TH FLOOR",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083212",
            "telephone_number": "860-282-0833",
            "fax_number": "860-282-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FOUNDERS PLZ",
            "address_2": "#300 C/O IPMS",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083212",
            "telephone_number": "860-282-4137",
            "fax_number": "860-282-0170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060321956",
            "country_code": "US",
            "telephone_number": "860-679-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARADIS",
        "first_name": "MARC",
        "middle_name": "ANDRE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2021-04-17",
        "certification_date": "2021-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "032335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001323352",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mparadis11681@direct.med.uchc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "263 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060321956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.