Individual provider Active NPI

Beth-Anne Lyn Roy, APRN

  • Gerontology Nurse Practitioner
  • Bloomfield, CT
National Provider Identifier
1033945951
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
12.014010 Issued in CT
Practice address
30 Loeffler Rd
Bloomfield, CT 06002-2256
Phone
(860) 380-5150
NPI assigned
Sep 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gerontology Nurse Practitioner 363LG0600X 12.014010 CT Primary

Addresses

Primary practice location

30 Loeffler Rd
Bloomfield, CT 06002-2256

Mailing address

4 Silver LN
Enfield, CT 06082-5823
Phone (413) 297-6696

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
I20241104001692 CT Practitioner - Nurse Practitioner 9638602253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians
McLean FundGroup PAC ID 0648247403, 105 clinicians

Practice addresses (Care Compare)

30 Loeffler Rd
Bloomfield, CT 06002-2256
Phone (860) 380-5150

75 Great Pond Rd
Simsbury, CT 06070-1980

Hospital & facility affiliations

  • Hartford Healthcare at Home Home health agency, East Hartford, CT, CCN 077041
  • Hartford Hospital Hospital, Hartford, CT, CCN 070025
  • Caleb Hitchcock Health Center Nursing home, Bloomfield, CT, CCN 075301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14010CTMDClinical Social Worker
12.014010CTMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Nov 15, 2024 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Nov 15, 2024 Accepting new patients

Locations

30 Loeffler Rd
Bloomfield, CT 06002
Phone (860) 380-5150

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: beth-anne.roy@xdr.hhchealthdirect.org

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1033945951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SILVER LN",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060825823",
            "telephone_number": "413-297-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LOEFFLER RD",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022256",
            "telephone_number": "860-380-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "BETH-ANNE",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "12.014010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

Verify at the official NPI Registry.