Individual provider Active NPI

Harold Eugene Phillips Jr., M.D.

  • Family Medicine Physician
  • Mystic, CT
National Provider Identifier
1124026869
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36959 Issued in CT
Practice address
3 Heron Rd
Mystic, CT 06355-3253
Phone
(860) 536-6442
Fax
(860) 536-6442
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME146710 FL
Geriatric Medicine (Family Medicine) Physician 207QG0300X 036959 CT
Hospitalist Physician 208M00000X ME146710 FL
Family Medicine Physician 207Q00000X 36959 CT Primary

Addresses

Primary practice location

3 Heron Rd
Mystic, CT 06355-3253

Mailing address

3 Heron Rd
Mystic, CT 06355-3253
Phone (860) 536-6442

Other identifiers 1

IdentifierTypeStateIssuer
001369596MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060724000286 CT Practitioner - Family Practice 7113947409 Reassigns benefits to 4 organizations
I20201111001572 FL Practitioner - Family PracticePractitioner - Hospitalist 7113947409 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Meharry Medical College School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians
Adventist Health System-Sunbelt IncGroup PAC ID 0749232445, shared by 8 NPIs, 100 clinicians

Practice addresses (Care Compare)

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260

4200 Sun N Lake Blvd
Sebring, FL 33872-1986
Phone (863) 314-4466

Hospital & facility affiliations

  • Adventhealth Sebring Hospital, Sebring, FL, CCN 100109

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36959CTMDFamily Medicine Physician
036959CTMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients
Adventist Health System-Sunbelt Inc Family Medicine CurrentSince Aug 15, 2021 Accepting new patients
Adventist Health System-Sunbelt Inc Family Medicine CurrentSince Aug 15, 2021 Accepting new patients
Hartford Healthcare Medical Group, Inc Family Medicine CurrentSince Dec 15, 2018 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Aug 15, 2021 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jun 1, 2019 Accepting new patients
Florida Hospital Physician Group Inc Family Medicine CurrentSince Aug 15, 2021 Accepting new patients
Ipc Hospitalists of New England, P.C. Family Medicine CurrentSince Nov 18, 2009 Accepting new patients
Conncare Inc Family Medicine Past Accepting new patients
Sound Medical Associates, PC Family Medicine Past Accepting new patients

Locations

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

365 Montauk Ave
Rm 4
New London, CT 06320

78 Viets St
New London, CT 06320
Phone (860) 447-1416

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

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

1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

522 Carlton St
Wauchula, FL 33873
Phone (863) 773-0975

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

25 Wells St
Westerly, RI 02891
Phone (401) 348-3325

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: harold.phillips@xdr.hhchealthdirect.org

Organizations & group practices 11

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.

Hospital & facility affiliations 1

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1124026869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HERON RD",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063553253",
            "telephone_number": "860-536-6442",
            "fax_number": "860-536-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HERON RD",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063553253",
            "telephone_number": "860-536-6442",
            "fax_number": "860-536-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "HAROLD",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME146710",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CT",
            "license": "036959",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME146710",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "36959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001369596",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mystic, CT

Sources for this page

Verify at the official NPI Registry.