NPIMap

Individual provider Active NPI

Gina L Williams, MD

  • Family Medicine Physician
  • Niantic, CT
National Provider Identifier
1023094158
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
049525 Issued in CT
Practice address
248 Flanders Rd
Niantic, CT 06357-1264
Phone
(860) 739-5426
Fax
(860) 739-0063
NPI assigned
Dec 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD12263 HI
Family Medicine Physician 207Q00000X 049525 CT Primary

Addresses

Primary practice location

248 Flanders Rd
Niantic, CT 06357-1264

Mailing address

248 Flanders Rd
Niantic, CT 06357-1264
Phone (860) 739-5426

Other identifiers 2

IdentifierTypeStateIssuer
121813OtherMEDICARE FQHC
51864901MedicaidHI

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
I20110419000085 CT Practitioner - Family Practice 3476589953 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
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)

23 Clara Dr
Mystic, CT 06355-1959
Phone (860) 572-5782

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
049525CTMDFamily Medicine Physician
MD12263HIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Hospitalists of New England, P.C. Family Medicine CurrentSince May 5, 2014 Accepting new patients
Ipc Hospitalists of New England PC Family Medicine CurrentSince May 5, 2014 Accepting new patients
Northeast Medical Group, Inc. CurrentSince Apr 1, 2017 Accepting new patients
Coastal Bend Academic Physcians PA Family Medicine Past Accepting new patients

Locations

226 Mill Hill Ave
Ste 3
Bridgeport, CT 06610
Phone (203) 384-3394

23 Clara Dr
Mystic, CT 06355
Phone (860) 443-7907

44 Maritime Dr
Mystic, CT 06355
Phone (860) 572-1700

31 Vauxhall St
New London, CT 06320
Phone (203) 789-1650

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

78 Viets St
New London, CT 06320
Phone (860) 447-1416

248 Flanders Rd
Niantic, CT 06357
Phone (860) 739-5426

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

Interoperability endpoints

  • Direct secure messaging: gwilliams329584@direct.ynhh.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 8

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1023094158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 FLANDERS RD",
            "city": "NIANTIC",
            "state": "CT",
            "postal_code": "063571264",
            "telephone_number": "860-739-5426",
            "fax_number": "860-739-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 FLANDERS RD",
            "city": "NIANTIC",
            "state": "CT",
            "postal_code": "063571264",
            "telephone_number": "860-739-5426",
            "fax_number": "860-739-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "GINA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-20",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD12263",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "049525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FQHC",
            "identifier": "121813",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51864901",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niantic, CT

Sources for this page

Verify at the official NPI Registry.