NPIMap

Individual provider Active NPI

Mitchell Gene Moffat, MD

  • Addiction Medicine (Internal Medicine) Physician
  • Rocky Hill, CT
National Provider Identifier
1174798060
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
031530 Issued in CT
Practice address
546 Cromwell Ave Ste 101
Rocky Hill, CT 06067-1898
Phone
(860) 757-3874
Fax
(860) 757-3875
NPI assigned
Apr 23, 2008
Last updated
Jul 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 031530 CT
Family Medicine Physician 207Q00000X 031530 CT
Addiction Medicine (Family Medicine) Physician 207QA0401X 031530 CT
Addiction Medicine (Internal Medicine) Physician 207RA0401X 031530 CT Primary
Hospitalist Physician 208M00000X 031530 CT

Addresses

Primary practice location

546 Cromwell Ave Ste 101
Rocky Hill, CT 06067-1898

Mailing address

546 Cromwell Ave Ste 101
Rocky Hill, CT 06067-1898
Phone (860) 757-3874

Other names 1

  • Dr. Mitchell Gene Moffat Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
031530CTMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anna Gut LLC Past Accepting new patients
Connecticut Addiction Medicine, LLC Addiction Medicine PastSince Oct 1, 2013 Accepting new patients

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": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1174798060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 CROMWELL AVE STE 101",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060671898",
            "telephone_number": "860-757-3874",
            "fax_number": "860-757-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 CROMWELL AVE STE 101",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060671898",
            "telephone_number": "860-757-3874",
            "fax_number": "860-757-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFAT",
        "first_name": "MITCHELL",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "031530",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "031530",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CT",
            "license": "031530",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "CT",
            "license": "031530",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "031530",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MITCHELL",
            "last_name": "MOFFAT",
            "middle_name": "GENE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rocky Hill, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.