Individual provider Active NPI

Allyson Michelle McDermott, M.D.

  • Pediatrics Physician
  • Hartford, CT
National Provider Identifier
1053705335
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
60562 Issued in CT
Practice address
282 Washington St
Hartford, CT 06106-3322
Phone
(860) 545-8391
NPI assigned
Mar 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 136148 CA
Pediatrics Physician 208000000X 60562 CT Primary

Addresses

Primary practice location

282 Washington St
Hartford, CT 06106-3322

Mailing address

27 Waterside LN
West Hartford, CT 06107-3523
Phone (516) 567-4942

Other names 1

  • Allyson Reid Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amcdermott40784@connecticutchildrens.direct-ci.com Connecticut Children's Specialty Group, Inc.

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
I20180613001118 CT Practitioner - Pediatric Medicine 5890087498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Connecticut School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children'S Specialty Group, Inc. Pediatrics CurrentSince Jun 1, 2018 Accepting new patients
Connecticut Children'S Specialty Group, Inc. Pediatrics CurrentSince Jun 1, 2018 Accepting new patients

Locations

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

Interoperability endpoints

  • Direct secure messaging: amcdermott40784@connecticutchildrens.direct-ci.com

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": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1053705335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 WATERSIDE LN",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061073523",
            "telephone_number": "516-567-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322",
            "telephone_number": "860-545-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "ALLYSON",
        "middle_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "136148",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "60562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amcdermott40784@connecticutchildrens.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Connecticut Children's Specialty Group, Inc.",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALLYSON",
            "last_name": "REID",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.