NPIMap

Individual provider Active NPI

Patti Mugo, MD

  • Family Medicine Physician
  • New London, CT
National Provider Identifier
1013272988
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
066927 Issued in CT
Practice address
4 Shaws CV Ste 103
New London, CT 06320-4956
Phone
(860) 443-3778
NPI assigned
Jul 6, 2012
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 29375 OK
Family Medicine Physician 207Q00000X 51076 AZ
Family Medicine Physician 207Q00000X 066927 CT Primary

Addresses

Primary practice location

4 Shaws CV Ste 103
New London, CT 06320-4956

Mailing address

1290 Silas Deane Hwy FL 1
Wethersfield, CT 06109-4337
Phone (860) 972-6970

Other identifiers 2

IdentifierTypeStateIssuer
067083MedicaidAZ
066927OtherCTCT LICENSE

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
I20201215001438 CT Practitioner - Family Practice 4385968932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

32 Sandy Desert Rd
Uncasville, CT 06382-1112
Phone (860) 464-3800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29375OKMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Mar 1, 2023 Accepting new patients
Hartford Healthcare Medical Group, Inc Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Northeast Medical Group Inc CurrentSince Mar 1, 2023 Accepting new patients
New London Family Practice, P.C. Family Medicine CurrentSince Dec 13, 2020 Accepting new patients
North Country Healthcare, Inc. Past Accepting new patients

Locations

4 Shaws Cv
Ste 103
New London, CT 06320
Phone (860) 443-3778

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

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

32 Sandy Desert Rd
Uncasville, CT 06382
Phone (860) 464-3800

1290 Silas Deane Hwy
Fl 1
Wethersfield, CT 06109
Phone (860) 972-6970

Interoperability endpoints

  • Direct secure messaging: pmugo612615@direct.ynhh.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1013272988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY FL 1",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "860-972-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SHAWS CV STE 103",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204956",
            "telephone_number": "860-443-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUGO",
        "first_name": "PATTI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": "29375",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "51076",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "066927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067083",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LICENSE",
            "identifier": "066927",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.