Individual provider Active NPI

Eleanor Elizabeth Stutz, M.D.

  • Psychiatry Physician
  • Waterbury, CT
National Provider Identifier
1043353337
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
025915 Issued in CT
Practice address
95 Thomaston Ave
Dmhas - Wcmhn
Waterbury, CT 06702-1007
Phone
(203) 805-5300
Fax
(203) 805-5310
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 025915 CT Primary

Addresses

Primary practice location

95 Thomaston Ave
Dmhas - Wcmhn
Waterbury, CT 06702-1007

Mailing address

95 Thomaston Ave
Dmhas - Wcmhn
Waterbury, CT 06702-1007
Phone (203) 805-5300

Other names 1

  • Eleanor Elizabeth Maier Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110324000434 CT Practitioner - Psychiatry 8921281254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Geisel School of Medicine at Dartmouth, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

1669 Thomaston Ave
Waterbury, CT 06704-1026
Phone (203) 759-3500

Hospital & facility affiliations

  • Saint Mary'S Hospital Hospital, Waterbury, CT, CCN 070016
  • Waterbury Hospital Hospital, Waterbury, CT, CCN 070005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
025915CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Jan 3, 2011 Accepting new patients
State of Connecticut CurrentSince Jan 3, 2011 Accepting new patients

Locations

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

55 W Main St
Ste 410
Waterbury, CT 06702
Phone (203) 805-6408

1669 Thomaston Ave
Waterbury, CT 06704
Phone (203) 759-3599

95 Thomaston Ave
Waterbury, CT 06702
Phone (203) 805-5300

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 2

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1043353337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 THOMASTON AVE",
            "address_2": "DMHAS - WCMHN",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021007",
            "telephone_number": "203-805-5300",
            "fax_number": "203-805-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 THOMASTON AVE",
            "address_2": "DMHAS - WCMHN",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021007",
            "telephone_number": "203-805-5300",
            "fax_number": "203-805-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTZ",
        "first_name": "ELEANOR",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "025915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELEANOR",
            "last_name": "MAIER",
            "middle_name": "ELIZABETH",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.