Individual provider Active NPI

Karla Renee Scanlon, DPM

  • Podiatrist
  • Willimantic, CT
National Provider Identifier
1063412971
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000656 Issued in CT
Practice address
162 Mansfield Ave
Willimantic, CT 06226-2061
Phone
(860) 456-4250
Fax
(860) 456-3745
NPI assigned
Jul 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 000656 CT Primary

Addresses

Primary practice location

162 Mansfield Ave
Willimantic, CT 06226-2061

Mailing address

162 Mansfield Ave
Willimantic, CT 06226-2061
Phone (860) 456-4250

Other practice location 1

1 Royce Cir
Storrs, CT 06268-2260
Phone (860) 487-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kscanlon35586@direct.med.uchc.edu

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071011000274 CT Practitioner - Podiatry 7517969868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Connecticut Health CenterGroup PAC ID 3678472016, 624 clinicians

Practice addresses (Care Compare)

1 Royce Cir
Suite 104
Storrs, CT 06268-2270
Phone (860) 487-9200

Hospital & facility affiliations

  • John Dempsey Hospital of the University of Connect Hospital, Farmington, CT, CCN 070036
  • Day Kimball Hospital Hospital, Putnam, CT, CCN 070003
  • Windham Community Memorial Hospital Hospital, Willimantic, CT, CCN 070021

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue119
Removal of nail tissue62
Removal or shaving of skin growth61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000656CTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Dec 20, 2019 Accepting new patients
University of Connecticut Health Center CurrentSince Dec 20, 2019 Accepting new patients
University of Connecticut Health Center Past Accepting new patients
Michael Scanlon Podiatrist PastSince Jan 1, 1996 Accepting new patients

Locations

21 South Rd
Farmington, CT 06032
Phone (860) 679-4600

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

1 Royce Cir
Ste 104
Storrs Mansfield, CT 06268
Phone (860) 487-9200

Interoperability endpoints

  • Direct secure messaging: kscanlon35586@direct.med.uchc.edu

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.

Hospital & facility affiliations 5

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1063412971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262061",
            "telephone_number": "860-456-4250",
            "fax_number": "860-456-3745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262061",
            "telephone_number": "860-456-4250",
            "fax_number": "860-456-3745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Royce Cir",
            "address_purpose": "LOCATION",
            "city": "Storrs",
            "state": "CT",
            "postal_code": "062682260",
            "country_code": "US",
            "telephone_number": "860-487-9200",
            "fax_number": "860-487-9222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCANLON",
        "first_name": "KARLA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "000656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kscanlon35586@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "Uconn Medical Group",
            "address_2": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.