NPIMap

Organization Active NPI

Hartford Healthcare at Home, Inc

  • Home Health Agency
  • Wethersfield, CT
National Provider Identifier
1073529566
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
C81721 Issued in CT
Legal business name
HARTFORD HEALTHCARE AT HOME, INC
Practice address
1290 Silas Deane Hwy Ste 4B
Wethersfield, CT 06109
Phone
(860) 249-4862
Fax
(860) 493-8598
NPI assigned
Aug 1, 2006
Last updated
Jun 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Authorized official

Name
Laurie St. John, RN, MSN
Title
VP Hartford Healthcare at Home
Phone
(860) 878-4848

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X C81721 CT Primary
Home Health Aide 374U00000X C81721 CT

Addresses

Primary practice location

1290 Silas Deane Hwy Ste 4B
Wethersfield, CT 06109

Mailing address

1290 Silas Deane Hwy
Suite 4B
Wethersfield, CT 06109-4337
Phone (860) 249-4862

Other identifiers 7

IdentifierTypeStateIssuer
253OtherCTBLUE CARE FAMILY PLAN
790049OtherCTCONNECTICARE
A471833OtherCTOXFORD
004042750MedicaidCT
004073268OtherCTCT COMMUNITY CARE INC
004130407OtherCTCT HOME CARE PROGRAM
253OtherCTANTHEM BCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030317000014 CT Part A Provider - Home Health Agency 6507775749 Practice locations: Bloomfield, CT; Bridgeport, CT; Mansfield Center, CT; Norwich, CT; Southington, CT; Torrington, CT; Watertown, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073529566. Details of each certification follow.

Home health agency certification: CCN 077041

Legal name
HARTFORD HEALTHCARE AT HOME, INC
Doing business as
HARTFORD HEALTHCARE AT HOME
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 1, 1966
Last certification
Jun 11, 2021
Ownership / control type
Proprietary
Organization structure
CorporationNon-profit
Incorporated
Dec 5, 1905 in CT
Enrollment address
1 Northwestern Dr
Ste 101
Bloomfield, CT 06002-3400
HHA Branch

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Hartford Healthcare at HomeCCN 077041 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Jul 1, 1966
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Cobius Healthcare Solutions2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gerald Boisvert Individual Corporate DirectorVice President Jul 1, 2019
W-2 Managing EmployeeVice President Jul 1, 2019
David Baranik Individual Corporate Director Nov 1, 2017
W-2 Managing EmployeeRegional VP of Finance Nov 1, 2017
Chibueze Agba Individual Corporate DirectorBoard of Director Dec 1, 2021
Hartford Healthcare Corporation Organization, Hartford, CT Corporation 5% Or Greater Direct Ownership Interest Oct 18, 2013 100%
Eric Smullen Individual Corporate DirectorBoard of Director Dec 1, 2021

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Greater Manchester Homecare, LLCVernon, CT, CCN 077003 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2026
Greater Manchester Homecare, LLCVernon, CT, CCN 071502 Hospice 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2026

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 17

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 17

Practitioners & affiliated clinicians

Affiliated clinicians 827

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 827

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1073529566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "address_2": "SUITE 4B",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "860-249-4862",
            "fax_number": "860-493-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY STE 4B",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "06109",
            "telephone_number": "860-249-4862",
            "fax_number": "860-493-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARTFORD HEALTHCARE AT HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "ST. JOHN",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "VP HARTFORD HEALTHCARE AT HOME",
        "authorized_official_telephone_number": "860-878-4848",
        "authorized_official_credential": "RN, MSN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CT",
            "license": "C81721",
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "CT",
            "license": "C81721",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE FAMILY PLAN",
            "identifier": "253",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "790049",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "A471833",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004042750",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT COMMUNITY CARE INC",
            "identifier": "004073268",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT HOME CARE PROGRAM",
            "identifier": "004130407",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "253",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

Verify at the official NPI Registry.