Individual provider Active NPI

Robert G Sutton, PH.D.

  • Clinical Psychologist
  • Glastonbury, CT
National Provider Identifier
1073532917
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
001165 Issued in CT
Practice address
55 Nye Rd
Glastonbury, CT 06033-1281
Phone
(860) 521-4788
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 001165 CT Primary

Addresses

Primary practice location

55 Nye Rd
Glastonbury, CT 06033-1281

Mailing address

20 Race Brook Rd
West Hartford, CT 06107-3110
Phone (860) 521-4788

Other identifiers 3

IdentifierTypeStateIssuer
5720095OtherCTAETNA
P622828OtherCTOXFORD HEALTH PLANS
060001165CT03OtherCTANTHEM BLUE CROSS BLUE SH

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110112000544 CT Practitioner - Clinical Psychologist 0840489472 Practice locations: Glastonbury, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Vermont College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

55 Nye Rd
Glastonbury, CT 06035-1281
Phone (860) 521-4788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
001165CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Geriatric and Family Psychiatry, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073532917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 RACE BROOK RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061073110",
            "telephone_number": "860-521-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NYE RD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331281",
            "telephone_number": "860-521-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "ROBERT",
        "middle_name": "G",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "001165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5720095",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P622828",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "060001165CT03",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.