Individual provider Active NPI

Michelle Louton Vanduinen, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Manchester, CT
National Provider Identifier
1063655561
Registry record updated May 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
004069 Issued in CT
Practice address
587 Middle Tpke E
Manchester, CT 06040-3731
Phone
(860) 646-3888
Fax
(860) 645-4132
NPI assigned
Apr 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 004069 CT Primary

Addresses

Primary practice location

587 Middle Tpke E
Manchester, CT 06040-3731

Mailing address

995 Day Hill Rd
Windsor, CT 06095-1722
Phone (860) 731-5522

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090729000812 CT Practitioner - Nurse Practitioner 4880747492 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

107 Wilcox Rd
Suite 105
Stonington, CT 06378-2614
Phone (860) 245-5811

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004069CTMDOccupational Therapist
4069CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Michelle Van Duinen Aprn PLLC Psychiatric/Mental Health CurrentSince Sep 16, 2019 Accepting new patients
Connecticut Mental Health Specialists Inc Psychiatric/Mental Health CurrentSince Apr 10, 2017 Accepting new patients
Masonicare Primary Care Physicians PastSince Oct 1, 2001 Accepting new patients
Masonicare Behavioral Health, LLC PastSince Dec 17, 2007 Accepting new patients
Community Health Resources, Inc. Past Accepting new patients

Locations

270 Farmington Ave
Ste 309
Farmington, CT 06032
Phone (860) 677-5570

107 Wilcox Rd
Ste 105
Stonington, CT 06378
Phone (650) 380-4395

Organizations & group practices 5

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 3

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": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1063655561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 DAY HILL RD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951722",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 MIDDLE TPKE E",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403731",
            "telephone_number": "860-646-3888",
            "fax_number": "860-645-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDUINEN",
        "first_name": "MICHELLE",
        "middle_name": "LOUTON",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-14",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "004069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.