Individual provider Active NPI

Anders Hogstrom, PH.D.

  • Clinical Neuropsychologist
  • Norwich, CT
National Provider Identifier
1043901325
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
4444 Issued in CT
Practice address
150 Otrobando Ave
Norwich, CT 06360-2116
Phone
(860) 889-7274
NPI assigned
May 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 4444 CT Primary

Addresses

Primary practice location

150 Otrobando Ave
Norwich, CT 06360-2116

Mailing address

150 Otrobando Ave
Norwich, CT 06360-2116
Phone (860) 889-7274

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230601001903 CT Practitioner - Clinical Psychologist 6305203654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Connecticut School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Neuropsychological Associates LLCGroup PAC ID 9638494446, 13 clinicians

Practice addresses (Care Compare)

150 Otrobando Ave
Norwich, CT 06360-2116
Phone (860) 889-7274

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Neuropsychological Associates, LLC Clinical Neuropsychologist CurrentSince May 15, 2023 Accepting new patients
Eastern Connecticut Rehabili PastSince May 15, 2023 Accepting new patients

Locations

150 Otrobando Ave
Norwich, CT 06360
Phone (860) 889-1948

10 N Main St
Ste 303
West Hartford, CT 06107
Phone (860) 792-4397

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.

NPI Registry JSON

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1043901325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 OTROBANDO AVE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602116",
            "telephone_number": "860-889-7274",
            "fax_number": "860-889-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 OTROBANDO AVE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602116",
            "telephone_number": "860-889-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGSTROM",
        "first_name": "ANDERS",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-17",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "4444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.