Michael David Baldwin, DO
Individual provider Active NPI Family Medicine Physician · Essex, CT
NPI 1104895382 · NPPES record last updated May 30, 2012
Key facts
- NPI
- 1104895382
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 000490 (CT)
- Practice address
- 10 Wildwood Medical Ctr
Essex, CT 06426-1154 - Phone
- (860) 767-0145
- NPI assigned
- Mar 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Prohealth Physicians PC
Practice addresses (Care Compare)
10 Wildwood Medical Ctr
Essex, CT 06426-1154
Phone (860) 767-0145
Hospital & facility affiliations
- Visiting Nurses of the Lower V
- Middlesex Health Care at Home and Hospice Program
- Yale New Haven Health - Health at Home
- Middlesex Hospital
- Yale-New Haven Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091203000471 | CT | Practitioner - Family Practice | 6800935834 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000490 | CT | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Physicians PC | Family Medicine | Current |
Accepting new patients |
Locations
3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200
115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810
Interoperability endpoints
- michael.baldwin.npi1104895382.phpct@direct.optumcare.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | 000490 | CT | |
| Family Medicine Physician | 207Q00000X | 000490 | CT | Yes |
Addresses
Primary practice location
10 Wildwood Medical Ctr
Essex, CT 06426-1154
Mailing address
10 Wildwood Medical Ctr
Essex, CT 06426-1154
Phone (860) 767-0145
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001004902 | Medicaid | CT |
Other providers in Essex, CT
- Suzanne E Arcuni
- Maria L Aresco
- Art Therapy & Creative Counseling
- Art Therapy & Creative Counseling LLC
- Vanessa Alecia Arthur
- Heather Michelle Barone
- Barrios and Silberstein PC
- Michael Vincent Barrios
- Ann Mabry Bates
- Megan Kinahan Biggs
All providers in Essex, CT · Family Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.