Active NPI
Tessa Hidalgo
- Licensed Practical Nurse
- Putnam, CT
National Provider Identifier
1073015749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 032361
- Practice address
- 391 Pomfret St
Putnam, CT 06260-1852 - Phone
- (860) 963-4971
- Fax
- (860) 963-4971
- NPI assigned
- Mar 8, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 032361 | CT | Primary |
Addresses
Primary practice location
391 Pomfret St
Putnam, CT 06260-1852
Mailing address
995 Day Hill Rd
Windsor, CT 06095-1722
Phone (860) 731-5522
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032361 | CT | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Resources, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Windsor, CT
- NPI 1215979810
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520467200000",
"number": "1073015749",
"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": "391 POMFRET ST",
"city": "PUTNAM",
"state": "CT",
"postal_code": "062601852",
"telephone_number": "860-963-4971",
"fax_number": "860-963-4971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIDALGO",
"first_name": "TESSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-08",
"last_updated": "2018-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "CT",
"license": "032361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Putnam, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.