Meghan B Brunnock, PA-C
Individual provider Active NPI Physician Assistant · Mystic, CT
NPI 1063500841 · NPPES record last updated Aug 7, 2019
Key facts
- NPI
- 1063500841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 000967 (CT)
- Practice address
- 34 Water Street
Suite 2
Mystic, CT 06355 - Phone
- (860) 572-9994
- Fax
- (860) 572-9930
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Duke University School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- John R. West MD Inc
Practice addresses (Care Compare)
34 Water St
Suite 2
Mystic, CT 06355-2524
Phone (860) 572-9994
Hospital & facility affiliations
- Lawrence & Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.31 of 100
- Quality
- 82.62
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161213000189 | CT | Practitioner - Physician Assistant | 4880974609 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eric R. Wolf, M.D., P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 000967 | CT | Yes |
Addresses
Primary practice location
34 Water Street
Suite 2
Mystic, CT 06355
Mailing address
34 Water Street
Suite 2
Mystic, CT 06355
Phone (860) 572-9994
Other providers in Mystic, CT
- Donna Jean Boulay
- Tiffany Bradley
- Howard Brensilver
- Barbara Jean Bronson
- Daniel Stubbs Brown
- Linda M Brustolon
- Kim Michelle Bucko
- Leah Bueneman
- Danielle Mae Buffington
- Stephanie Buske
All providers in Mystic, CT · Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.