Individual provider Active NPI

Demetra Eleftheriou, MD

  • Family Medicine Physician
  • Farmington, CT
National Provider Identifier
1104838812
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
039042 Issued in CT
Practice address
3 Farm Glen Blvd
Farmington, CT 06032-1981
Phone
(860) 284-5266
Fax
(860) 409-4077
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 039042 CT Primary

Addresses

Primary practice location

3 Farm Glen Blvd
Farmington, CT 06032-1981

Mailing address

3 Farm Glen Blvd
Farmington, CT 06032-1981
Phone (860) 284-5266

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121004000669 CT Practitioner - Family Practice 3577689843 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
039042CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc Family Medicine CurrentSince Mar 14, 2020 Accepting new patients
Prohealth Physicians PC Family Medicine CurrentSince Sep 4, 2012 Accepting new patients
New York Walk-in Medical Group, PC Family Medicine Past Accepting new patients

Locations

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

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

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Organizations & group practices 3

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1104838812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 FARM GLEN BLVD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321981",
            "telephone_number": "860-284-5266",
            "fax_number": "860-409-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 FARM GLEN BLVD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321981",
            "telephone_number": "860-284-5266",
            "fax_number": "860-409-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELEFTHERIOU",
        "first_name": "DEMETRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "039042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.