Individual provider Active NPI

Christopher Tagliavini, PA-C

  • Surgical Physician Assistant
  • Bristol, CT
National Provider Identifier
1104228022
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
3201 Issued in CT
Practice address
22 Pine St
Bristol, CT 06010-6948
Phone
(860) 584-8291
Fax
(860) 584-8354
NPI assigned
Sep 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 3201 CT Primary

Addresses

Primary practice location

22 Pine St
Bristol, CT 06010-6948

Mailing address

149 Prospect St
Suffield, CT 06078-3006
Phone (860) 584-8291

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141112001671 CT Practitioner - Physician Assistant 5890917546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc CurrentSince Oct 15, 2014 Accepting new patients
Hartford Healthcare Medical Group, Inc Past Accepting new patients

Locations

385 W Main St
Avon, CT 06001
Phone (860) 777-1280

22 Pine St
Bristol, CT 06010
Phone (860) 229-8346

22 Pine St
Ste 104
Bristol, CT 06010
Phone (860) 314-2002

280 S Main St
Ste 204
Cheshire, CT 06410
Phone (203) 224-5161

10 Birdseye Rd
Ste 100
Farmington, CT 06032
Phone (860) 678-2683

330 Western Blvd
Ste 200
Glastonbury, CT 06033

85 Seymour St
Ste 416
Hartford, CT 06106
Phone (860) 522-4158

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

455 Lewis Ave
Ste 210
Meriden, CT 06451
Phone (203) 238-1241

100 Grand St
#B
New Britain, CT 06052

330 Washington St
Ste 350
Norwich, CT 06360
Phone (860) 886-1956

201 N Mountain Rd
Ste 201
Plainville, CT 06062
Phone (860) 223-0800

462 Queen St
Ste 203
Southington, CT 06489
Phone (860) 628-3518

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

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

65 Memorial Rd
Ste 430
West Hartford, CT 06107
Phone (860) 231-0751

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: christopher.tagliavini@xdr.hhchealthdirect.org

Organizations & group practices 2

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1104228022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 PROSPECT ST",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060783006",
            "telephone_number": "860-584-8291",
            "fax_number": "860-584-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PINE ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106948",
            "telephone_number": "860-584-8291",
            "fax_number": "860-584-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGLIAVINI",
        "first_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "3201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.