Individual provider Active NPI

Ralph Frank Hirschfeld, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Putnam, CT
National Provider Identifier
1144523077
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5793 Issued in CT
Practice address
202 Pomfret St
Putnam, CT 06260-1833
Phone
(860) 963-7917
Fax
(860) 963-0015
NPI assigned
Dec 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 5793 CT
Family Nurse Practitioner 363LF0000X 5793 CT Primary

Addresses

Primary practice location

202 Pomfret St
Putnam, CT 06260-1833

Mailing address

40 Mansfield Ave
Willimantic, CT 06226-2018
Phone (860) 450-7471

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
I20141126001513 CT Practitioner - Nurse Practitioner 1658693742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Connecticut Behavioral Health Assoc PCGroup PAC ID 4385532373, 38 clinicians

Practice addresses (Care Compare)

41 Faire Harbour PL
New London, CT 06320-4710
Phone (860) 437-6914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5793CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Behavioral Health Assoc, P.C. CurrentSince May 10, 2021 Accepting new patients

Locations

616 Gold Star Hwy
Groton, CT 06340
Phone (860) 449-0020

41 Faire Harbour Pl
New London, CT 06320
Phone (860) 437-6914

22 Case St
Norwich, CT 06360
Phone (860) 437-6914

Interoperability endpoints

  • Direct secure messaging: ralph.hirschfeld.1@32885.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413417600000",
    "number": "1144523077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262018",
            "telephone_number": "860-450-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601833",
            "telephone_number": "860-963-7917",
            "fax_number": "860-963-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSCHFELD",
        "first_name": "RALPH",
        "middle_name": "FRANK",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-15",
        "last_updated": "2014-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "5793",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "5793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Putnam, CT

Sources for this page

Verify at the official NPI Registry.