Individual provider Active NPI

Melissa Ruth Goclowski, APRN

  • Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1124377536
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
005083 Issued in CT
Practice address
31 Seymour St
Ste 100
Hartford, CT 06106-5521
Phone
(860) 549-3210
Fax
(860) 247-3803
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 005083 CT Primary

Addresses

Primary practice location

31 Seymour St
Ste 100
Hartford, CT 06106-5521

Mailing address

270 Farmington Ave
Suite 102
Farmington, CT 06032
Phone (860) 549-8276

Other identifiers 1

IdentifierTypeStateIssuer
005083OtherCTAPRN LICENSE

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
I20121012000108 CT Practitioner - Nurse Practitioner 9032368741 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford HospitalGroup PAC ID 2567366016, shared by 6 NPIs, 1,040 clinicians

Practice addresses (Care Compare)

80 Seymour St
Hartford, CT 06102-8000

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5083CTMDOccupational Therapist
005083CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Jun 4, 2018 Accepting new patients
Hartford Hospital CurrentSince Jun 4, 2018 Accepting new patients
Orthopedic Associates of Hartford,PC CurrentSince Sep 4, 2012 Accepting new patients
Orthopedic Associates of Hartford,PC CurrentSince Sep 4, 2012 Accepting new patients

Locations

100 Hazard Ave
Enfield, CT 06082
Phone (860) 696-2380

270 Farmington Ave
Ste 102
Farmington, CT 06032

499 Farmington Ave
Ste 300
Farmington, CT 06032
Phone (860) 549-8986

345 Western Blvd
Glastonbury, CT 06033
Phone (860) 549-8288

32 Seymour St
Hartford, CT 06106
Phone (860) 972-1128

31 Seymour St
Fl 2
Hartford, CT 06106
Phone (860) 972-0050

31 Seymour St
Ste 100
Hartford, CT 06106
Phone (860) 549-8208

85 Seymour St
Ste 607
Hartford, CT 06106
Phone 8605493210 ext. 8979

1000 Asylum Ave
Hartford, CT 06105
Phone (860) 714-4532

505 Willard Ave
Bldg A
Newington, CT 06111

201 N Mountain Rd
Ste 3
Plainville, CT 06062

1111 Cromwell Ave
Ste 301
Rocky Hill, CT 06067
Phone (860) 244-8857

Organizations & group practices 4

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 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": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1124377536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 FARMINGTON AVE",
            "address_2": "SUITE 102",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06032",
            "telephone_number": "860-549-8276",
            "fax_number": "860-674-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 SEYMOUR ST",
            "address_2": "STE 100",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065521",
            "telephone_number": "860-549-3210",
            "fax_number": "860-247-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOCLOWSKI",
        "first_name": "MELISSA",
        "middle_name": "RUTH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "005083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "005083",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.