Individual provider Active NPI

Julian Ford, PHD

  • Psychologist
  • Farmington, CT
National Provider Identifier
1083612477
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
002218 Issued in CT
Practice address
10 Talcott Notch Rd
Farmington, CT 06032-1800
Phone
(860) 679-6700
Fax
(860) 679-6736
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 002218 CT Primary

Addresses

Primary practice location

10 Talcott Notch Rd
Farmington, CT 06032-1800

Mailing address

263 Farmington Ave
Provider Enrollment
Farmington, CT 06030-2212
Phone (860) 679-7503

Other identifiers 3

IdentifierTypeStateIssuer
004192423MedicaidCT
680001801OtherCTMEDICARE PIN UNDER GROUP PTAN C00060
680001695OtherCTMEDICARE PIN UNDER GROUP PTAN C00025

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jford10746@direct.med.uchc.edu

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
I20050607000532 CT Practitioner - Clinical Psychologist 9133162548 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
State University of New York at Stony Brook, School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002218CTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Jul 1, 2006 Accepting new patients
State of Connecticut CurrentSince Jul 21, 2018 Accepting new patients
State of Connecticut Psychologist CurrentSince Jul 21, 2018 Accepting new patients
University of Connecticut Health Center CurrentSince Jul 1, 2006 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

10 Talcott Notch Rd
Farmington, CT 06032
Phone (860) 679-6700

Interoperability endpoints

  • Direct secure messaging: jford10746@direct.med.uchc.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1083612477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060302212",
            "telephone_number": "860-679-7503",
            "fax_number": "860-679-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TALCOTT NOTCH RD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321800",
            "telephone_number": "860-679-6700",
            "fax_number": "860-679-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "JULIAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "002218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004192423",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN UNDER GROUP PTAN C00060",
            "identifier": "680001801",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN UNDER GROUP PTAN C00025",
            "identifier": "680001695",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jford10746@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "Uconn Medical Group",
            "address_2": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.