Individual provider Active NPI

Melissa A Moynihan

  • Nurse Practitioner
  • Enfield, CT
National Provider Identifier
1043032444
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
14124 Issued in CT
Practice address
9 Cranbrook Blvd FL 2
Enfield, CT 06082-3889
Phone
(833) 538-7464
NPI assigned
Oct 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 14124 CT Primary

Addresses

Primary practice location

9 Cranbrook Blvd FL 2
Enfield, CT 06082-3889

Mailing address

50 Cone St
Manchester, CT 06040-4450

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
I20250918003008 CT Practitioner - Nurse Practitioner 2961906391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

94 Connecticut Blvd
East Hartford, CT 06108-3013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14124CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Health Centers, Inc. CurrentSince Jul 13, 2025 Accepting new patients
First Choice Health Centers, Inc. Current Accepting new patients
First Choice Health Centers, Inc. CurrentSince Jul 13, 2025 Accepting new patients
Sone Health Medical Group, PLLC Past Accepting new patients

Locations

94 Connecticut Blvd
Hartford, CT 06108
Phone (860) 610-6191

150 N Main St
Manchester, CT 06042
Phone (860) 533-3434

150 N Main St
Ste 240
Manchester, CT 06042
Phone (860) 610-6191

Interoperability endpoints

  • Direct secure messaging: melissa.moynihan.1@31837.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1043032444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CONE ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CRANBROOK BLVD FL 2",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823889",
            "telephone_number": "833-538-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYNIHAN",
        "first_name": "MELISSA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-28",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "14124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.