Ellen A Dornelas, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

002046 Issued in CT

Practice address

80 Seymour Street
Hartford Hospital Oncology Depg
Hartford, CT 06102-5037

Phone

(860) 545-3790

NPI assigned

Aug 14, 2006

Last updated

Jul 23, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Centered Health Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • Hartford, CT
  • NPI 1609025394
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1083627608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415933",
            "address_2": "HARTFORD HOSPITAL PROFESSIONAL SERVICES",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415933",
            "telephone_number": "860-545-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL ONCOLOGY DEPG",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-545-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNELAS",
        "first_name": "ELLEN",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008020463",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brennan William Donville, MD
• Kelsey Doolittle
• Dianne Doot, M.D.
• Matthew Dorazio, DO
• Nathan Dorian, APRN
• Luiza Doro Pereira, MD
• Claire Eileen Dorr
• Kimberly Ann Dorsett, PH.D.
• Morgan A Dorsey, PHYSICIAN ASSISTANT
• James E Dougherty, M.D.

• Clinical Psychologist in Hartford, CT
• Providers in Hartford, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.