Michael Ryan Stclair, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

003275 Issued in CT

Practice address

80 Seymour St
Hartford Hospital Medicine Dept
Hartford, CT 06102-5037

Phone

(860) 972-2085

NPI assigned

Jan 19, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Northwestern Medical Center, Inc.

  • General Acute Care Hospital
  • Saint Albans, VT
  • NPI 1720112659
  Medicare reassignment NPD
• Northwestern Medical Center, Inc.

  • General Acute Care Hospital
  • Saint Albans, VT
  • NPI 1538293469
  Medicare reassignment
• Northwestern Medical Center Inc

  • General Acute Care Hospital
  • Saint Albans, VT
  • NPI 1538442199
  NPD
• Northwestern Medical Center, Inc

  • Pediatrics Physician
  • Saint Albans, VT
  • NPI 1003574740
  NPD
• Northwestern Medical Center, Inc.

  • Cardiovascular Disease Physician
  • Saint Albans, VT
  • NPI 1295034304
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1124417852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL MEDICINE DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-972-2085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "address_2": "HARTFORD HOSPITAL MEDICINE DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-972-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STCLAIR",
        "first_name": "MICHAEL",
        "middle_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-19",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "003275",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "003275",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "003275",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garrison J Starrett, DO
• State of Connecticut
• State of Connecticut Office of the Comptroller
• State of CT. - Office of the Comptroller
• Ann-Marie P Stawarky, APRN
• Naomi Ruth Steadman, LCSW
• Christina Maria Stefanides, LMSW
• Cheryl Stefanik, BSN,
• Barry Stein, M.D.
• Gary Samuel Stein, MD

• Medical Physician Assistant in Hartford, CT
• Providers in Hartford, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.