Individual provider Active NPI

Elizabeth Anna Ta, DO

  • Family Medicine Physician
  • Middletown, CT
National Provider Identifier
1134869795
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
85037 Issued in CT
Practice address
28 Crescent St
Middletown, CT 06457-3654
Phone
(860) 358-6000
NPI assigned
Mar 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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 85037 CT Primary

Addresses

Primary practice location

28 Crescent St
Middletown, CT 06457-3654

Mailing address

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-6000

Other practice location 1

70 Shunpike Rd
Cromwell, CT 06416-2416
Phone (860) 358-5280

Other practice location 2

675 Main St
Middletown, CT 06457-2732
Phone (860) 347-6971

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
I20220725000058 CT Order and Referring Only - Family PracticePractitioner - Family Practice 2961883848

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middlesex HospitalGroup PAC ID 5092611731, shared by 7 NPIs, 231 clinicians

Practice addresses (Care Compare)

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-5322

Hospital & facility affiliations

  • Middlesex Hospital Hospital, Middletown, CT, CCN 070020

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: eta71707@middlesexhealthprd.direct-ci.com

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": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1134869795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Shunpike Rd",
            "address_purpose": "LOCATION",
            "city": "Cromwell",
            "state": "CT",
            "postal_code": "064162416",
            "country_code": "US",
            "telephone_number": "860-358-5280",
            "fax_number": "860-358-8650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "675 Main St",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "064572732",
            "country_code": "US",
            "telephone_number": "860-347-6971",
            "fax_number": "860-343-7379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TA",
        "first_name": "ELIZABETH",
        "middle_name": "ANNA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "85037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.