Individual provider Active NPI

Samantha Garabedian, APRN

  • Family Nurse Practitioner
  • Middletown, CT
National Provider Identifier
1164297602
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12203 Issued in CT
Practice address
420 Saybrook Rd
Middletown, CT 06457-4859
Phone
(203) 678-1050
NPI assigned
Nov 15, 2023
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12203 CT Primary

Addresses

Primary practice location

420 Saybrook Rd
Middletown, CT 06457-4859

Mailing address

420 Saybrook Rd
Middletown, CT 06457-4859
Phone (203) 678-1050

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
I20240125000157 CT Practitioner - Nurse Practitioner 8921451030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

420 Saybrook Rd
Middletown, CT 06457-4747
Phone (860) 636-2010

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Feb 1, 2024 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Feb 1, 2024 Accepting new patients

Locations

420 Saybrook Rd
Middletown, CT 06457
Phone (860) 347-4258

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

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1164297602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SAYBROOK RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574859",
            "telephone_number": "203-678-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 SAYBROOK RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574859",
            "telephone_number": "203-678-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARABEDIAN",
        "first_name": "SAMANTHA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-15",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.