Rachel Fortune, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

51267 Issued in CT

Practice address

64 Double Hill Rd
Bethlehem, CT 06751-1101

Phone

(303) 854-8888

NPI assigned

Jan 24, 2007

Last updated

Jul 11, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Walden Behavioral Care LLC

  • Psychiatric Hospital
  • Dedham, MA
  • NPI 1992778781
  Medicare reassignment

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1184779555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 RICHARD SWEET DR",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065251126",
            "telephone_number": "303-854-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 DOUBLE HILL RD",
            "city": "BETHLEHEM",
            "state": "CT",
            "postal_code": "067511101",
            "telephone_number": "303-854-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNE",
        "first_name": "RACHEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CT",
            "license": "51267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49437518",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Caruso, MSW
• Dawyn Cloud Alter, LMFT
• Jennifer Detlefsen, ATC, MHA
• Kathy A Dowling, LMFT
• Erin M Fitch, PMHNP-BC
• Gina Marie Funicello, LMSW
• Sharon R Gomes, LCSW
• Healing Hoofbeats of CT, Inc
• Keith H. Wade DMD PC
• Kenneth Meady (Towne Apothecary LLCC)

• Pediatric Adolescent Medicine Physician in Bethlehem, CT
• Providers in Bethlehem, CT by specialty
• Pediatric Adolescent Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.