Suzanne M Powell, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

042791 Issued in CT

Practice address

12A Ledgebrook Dr
Mansfield Center, CT 06250-1690

Phone

(860) 423-2960

Fax

(860) 423-3719

NPI assigned

Oct 11, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: suzanne.powell.npi1013905363.phpct@direct.optumcare.masshiway.net
• FHIR API: https://api.platform.athenahealth.com/1694/brand/19/csg/48/fhir/r4

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.

• Day Kimball Medical Group Inc

  • Family Medicine Physician
  • Putnam, CT
  • NPI 1376813972

  Pediatrics

  Medicare reassignment NPD
• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  Pediatrics

  Medicare reassignment NPD
• Mansfield Pediatrics LLC

  • Pediatrics Physician
  • Mansfield Center, CT
  • NPI 1285729780
  NPD (past)

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1013905363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601836",
            "telephone_number": "860-963-6390",
            "fax_number": "860-963-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12A LEDGEBROOK DR",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501690",
            "telephone_number": "860-423-2960",
            "fax_number": "860-423-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "SUZANNE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "042791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001427914",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandy Petrone, LMSW
• John Anthony Phelps, LMFT
• Alexis Pilkington, LMSW
• Chastity J Pimental, LCSW
• Barbara Cynthia Pottinger, APRN
• Candace F Powers, LCSW
• Allison Price, LMFT
• Professional Resource Group PC
• Chad Edward Quensen, MFT
• Champakamala Honganur Rajanna, M.D.,

• Pediatrics Physician in Mansfield Center, CT
• Providers in Mansfield Center, CT by specialty
• Pediatrics Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.