Individual provider Active NPI

Michelle Malz

  • Primary Care Nurse Practitioner
  • Manchester, CT
National Provider Identifier
1033805296
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
11881 Issued in CT
Practice address
315 E Center St
Manchester, CT 06040-3315
Phone
(860) 533-0179
NPI assigned
Apr 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 11881 CT Primary
Registered Nurse 163W00000X 143177 CT

Addresses

Primary practice location

315 E Center St
Manchester, CT 06040-3315

Mailing address

47B Carillon Dr
Rocky Hill, CT 06067-2501

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260227002594 CT Practitioner - Nurse Practitioner 1759862600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Collaborative Natural Health Partners, LLCGroup PAC ID 4688169683, 5 clinicians

Practice addresses (Care Compare)

315 E Ctr St
Manchester, CT 06040-5251
Phone (860) 533-0179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
143177CTMDRegistered Nurse
11881CTMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Collaborative Natural Health Partners, LLC CurrentSince Jan 18, 2026 Accepting new patients

Locations

1 Northwestern Dr
Ste 202
Bloomfield, CT 06002
Phone (860) 233-8589

315 E Center St
Manchester, CT 06040
Phone (860) 533-0179

244 Farms Village Rd
Ste L
West Simsbury, CT 06092

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDJFCA/Endpoint/IDJFCA

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1033805296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47B CARILLON DR",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060672501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403315",
            "telephone_number": "860-533-0179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALZ",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "11881",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "143177",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.