NPIMap

Organization Active NPI

MHS Primary Care Inc

Doing business as Middlesex Hospital Urgent Care

  • Urgent Care Clinic/Center
  • Old Saybrook, CT
National Provider Identifier
1093138935
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MHS PRIMARY CARE INC
Doing business as
Middlesex Hospital Urgent Care
Practice address
154 Main St
Old Saybrook, CT 06475-2373
Phone
(860) 661-5976
Fax
(860) 358-8664
NPI assigned
Jan 29, 2014
Last updated
Apr 7, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MHS PRIMARY CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Authorized official

Name
Susan Martin
Title
VP Finance
Phone
(860) 358-3005

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X CT Primary
Physician Assistant 363A00000X CT
Medical Physician Assistant 363AM0700X
Adult Health Nurse Practitioner 363LA2200X
Family Nurse Practitioner 363LF0000X CT
Family Medicine Physician 207Q00000X CT
Internal Medicine Physician 207R00000X CT

Addresses

Primary practice location

154 Main St
Old Saybrook, CT 06475-2373

Mailing address

28 Crescent St
Middlesex Hospital Urgent Care
Middletown, CT 06457-3654
Phone (860) 358-4870

Other practice location 1

146 Samson Rock Dr
Middlesex Hospital Urgent Care Madison
Madison, CT 06443-3018
Phone (203) 779-5207

Other practice location 2

896 Washington St
Middletown, CT 06457-2912
Phone (860) 788-3632

Other identifiers 4

IdentifierTypeStateIssuer
008061268MedicaidCT
008061130MedicaidCT
008050108MedicaidCT
008050909MedicaidCT

Other names 1

  • Middlesex Hospital Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140814001234 CT Part B Supplier - Clinic/Group Practice 4082507371 Receives reassigned benefits from 52 practitioners
Practice locations: Middletown, CT; Old Saybrook, CT

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Part of
MHS Primary Care Inc

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649289600000",
    "number": "1093138935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "address_2": "MIDDLESEX HOSPITAL URGENT CARE",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-4870",
            "fax_number": "860-358-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 MAIN ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752373",
            "telephone_number": "860-661-5976",
            "fax_number": "860-358-8664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "146 Samson Rock Dr",
            "address_2": "Middlesex Hospital Urgent Care Madison",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "CT",
            "postal_code": "064433018",
            "country_code": "US",
            "telephone_number": "203-779-5207",
            "fax_number": "203-779-5792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "896 Washington St",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "064572912",
            "country_code": "US",
            "telephone_number": "860-788-3632",
            "fax_number": "860-788-2085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MHS PRIMARY CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MHS PRIMARY CARE INC",
        "enumeration_date": "2014-01-29",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "860-358-3005"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CT",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008061268",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008061130",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008050108",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008050909",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middlesex Hospital Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Middlesex Hospital Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Old Saybrook, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.