NPIMap

Individual provider Active NPI

Matthew Rodziewicz, PA-C

  • Medical Physician Assistant
  • Hartford, CT
National Provider Identifier
1093344301
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5272 Issued in CT
Practice address
80 Seymour St
Hartford, CT 06102-8000
Phone
(860) 972-0542
NPI assigned
Apr 7, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5272 CT Primary

Addresses

Primary practice location

80 Seymour St
Hartford, CT 06102-8000

Mailing address

118 Cherry Hill Dr
Bristol, CT 06010-2573

Other practice location 1

118 Cherry Hill Dr
Bristol, CT 06010-2573
Phone (860) 637-0294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210727001149 CT Practitioner - Physician Assistant 1658774799 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 827-7695

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 972-0549

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

Merit-based Incentive Payment System (MIPS)

Final score
95.62 of 100Reported as group
Quality
84.96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Aug 1, 2021 Accepting new patients
Hartford Hospital CurrentSince Jan 1, 2024 Accepting new patients
Midstate Medical Center CurrentSince Oct 1, 2023 Accepting new patients
Hartford Hospital CurrentSince Jan 1, 2024 Accepting new patients
Midstate Medical Center CurrentSince Oct 1, 2023 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

61 Pomeroy Ave
Unit 1
Meriden, CT 06450
Phone (203) 694-5340

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

Interoperability endpoints

  • Direct secure messaging: matthew.rodziewicz@xdr.hhchealthdirect.org

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1093344301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CHERRY HILL DR",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060102573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061028000",
            "telephone_number": "860-972-0542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 Cherry Hill Dr",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "CT",
            "postal_code": "060102573",
            "country_code": "US",
            "telephone_number": "860-637-0294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODZIEWICZ",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "5272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.