Individual provider Active NPI

Gladys Quinones, APRN

  • Primary Care Nurse Practitioner
  • West Hartford, CT
National Provider Identifier
1184656647
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
002324 Issued in CT
Practice address
1007 Farmington Ave Ste 3a
West Hartford, CT 06107-2107
Phone
(860) 570-4882
Fax
(860) 570-4885
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 002324 CT
Primary Care Nurse Practitioner 363LP2300X 002324 CT Primary

Addresses

Primary practice location

1007 Farmington Ave Ste 3a
West Hartford, CT 06107-2107

Mailing address

1007 Farmington Ave Ste 3a
West Hartford, CT 06107-2107
Phone (860) 570-4882

Other identifiers 3

IdentifierTypeStateIssuer
004215316MedicaidCT
2V8743OtherHEALTHNET
400002324CT05OtherCTANTHEM

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
I20040420000315 CT Practitioner - Nurse Practitioner 2769477538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

342 N Main St
Suite 310
West Hartford, CT 06117-2500
Phone (860) 803-3251

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002324CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Solutions CurrentSince Jan 1, 2022 Accepting new patients
Psych Solutions LLC Nurse Practitioner PastSince Nov 1, 2007 Accepting new patients
Medoptions Behavioral Health Assoc, LLC Nurse Practitioner Past Accepting new patients
Dr. Roberto Medina, MD LLC Past Accepting new patients
Hartford Community Mental Health Center Inc. PastSince Jul 10, 2011 Accepting new patients

Locations

342 N Main St
#310
West Hartford, CT 06117
Phone (860) 803-3251

342 N Main St
Ste 310
West Hartford, CT 06117
Phone (860) 570-4882

Organizations & group practices 5

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1184656647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 FARMINGTON AVE STE 3A",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072107",
            "telephone_number": "860-570-4882",
            "fax_number": "860-570-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 FARMINGTON AVE STE 3A",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072107",
            "telephone_number": "860-570-4882",
            "fax_number": "860-570-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINONES",
        "first_name": "GLADYS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "002324",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "002324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004215316",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2V8743",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "400002324CT05",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.