Individual provider Active NPI

Margarita Hernandez, P.H.D

  • Clinical Psychologist
  • Wethersfield, CT
National Provider Identifier
1073775268
Registry record updated Mar 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
002171 Issued in CT
Practice address
55 Town Line Rd
Suite 101
Wethersfield, CT 06109-4352
Phone
(860) 757-3702
Fax
(860) 757-3725
NPI assigned
Jun 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2012

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 002171 CT Primary

Addresses

Primary practice location

55 Town Line Rd
Suite 101
Wethersfield, CT 06109-4352

Mailing address

55 Town Line Rd
Suite #101
Wethersfield, CT 06109-4352
Phone (860) 757-3702

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
I20101011000755 CT Practitioner - Clinical Psychologist 2062538549 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002171CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince Nov 15, 2017 Accepting new patients
Middlesex Hospital CurrentSince Nov 15, 2017 Accepting new patients
Comprehensive Psychological & Assessment Services LLC Clinical CurrentSince Jun 1, 2011 Accepting new patients

Locations

21 Pleasant St
Middletown, CT 06457
Phone (860) 344-8224

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

55 Town Line Rd
Ste 101
Wethersfield, CT 06109
Phone (860) 757-3702

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1214611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330732800000",
    "number": "1073775268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 TOWN LINE RD",
            "address_2": "SUITE #101",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094352",
            "telephone_number": "860-757-3702",
            "fax_number": "860-757-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 TOWN LINE RD",
            "address_2": "SUITE 101",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094352",
            "telephone_number": "860-757-3702",
            "fax_number": "860-757-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MARGARITA",
        "name_prefix": "Dr.",
        "credential": "P.H.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-28",
        "last_updated": "2012-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

Verify at the official NPI Registry.