Paul Niedbala

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10296 Issued in CT

Practice address

91 Voluntown Rd
Pawcatuck, CT 06379-1389

Phone

(860) 599-5477

NPI assigned

Mar 18, 2022

Last updated

Mar 18, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ptsma IncGroup PAC ID 7911800180, shared by 11 NPIs, 173 clinicians

Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
• Westerly Hospital Hospital, Westerly, RI, CCN 410013

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

86.54

Promoting interoperability

99.98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pniedbala320918@direct.ynhh.org
• Direct secure messaging: pniedbala80004@middlesexhealthprd.direct-ci.com

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.

• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  Medicare reassignment Care Compare group NPD
• MHS Primary Care Inc

  dba Middlesex Hospital Urgent Care

  • Urgent Care Clinic/Center
  • Old Saybrook, CT
  • NPI 1093138935

  Family

  Medicare reassignment NPD
• MHS Primary Care Inc

  dba Middlesex Health Concierge Medicine

  • Internal Medicine Physician
  • Essex, CT
  • NPI 1750276655
  NPD
• Mill Hill Medical Consultants Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • New Haven, CT
  • NPI 1891019675
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lawrence and Memorial Hospital, Inc.

  dba Lawrence and Memorial Hospital

  • General Acute Care Hospital
  • New London, CT
  • NPI 1073530879
  Care Compare affiliation
• Lawrence and Memorial Hospital, Inc.

  dba Lawrence and Memorial Hospital

  • General Acute Care Hospital
  • New London, CT
  • NPI 1700092459
  Care Compare affiliation
• LMW Healthcare Inc.

  dba Westerly Hospital

  • General Acute Care Hospital
  • Westerly, RI
  • NPI 1447595368
  Care Compare affiliation

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1194474122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BANKER CT",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063791345",
            "telephone_number": "860-235-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 VOLUNTOWN RD",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063791389",
            "telephone_number": "860-599-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDBALA",
        "first_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "10296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela G Moore, APRN
• Karen Marie Murphy, PHYSICIAN ASSISTANT
• Natural Family Health & Integrative Medicine, LLC
• New England Developmental Center
• Jacqueline M. Nichols-Holden, LMT
• Todd M Parrilla, DO
• James Pendergast III, LCSW
• Kerry Marie Phelan, PA-C
• Stephen Joseph Phelan, M.D.
• Pmcrx Inc (McQuades Pharmacy)

• Family Nurse Practitioner in Pawcatuck, CT
• Providers in Pawcatuck, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.