Active NPI
Michelle Malz
- Primary Care Nurse Practitioner
- Manchester, CT
National Provider Identifier
1033805296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 11881
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
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
| License | State | Type | Specialty |
|---|---|---|---|
| 143177 | CT | MD | Registered Nurse |
| 11881 | CT | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collaborative Natural Health Partners, LLC | Current | 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
- 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.
-
- Family Medicine Physician
- Manchester, CT
- NPI 1396267126
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.