Mark D Tuttle, M.D.
Individual provider Active NPI Family Medicine Physician · Marlborough, CT
NPI 1194737130 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1194737130
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 018271 (CT)
- Practice address
- 14 Jones Hollow Rd
Marlborough, CT 06447-1448 - Phone
- (860) 295-8217
- Fax
- (860) 295-9734
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Connecticut School of Medicine, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Prohealth Physicians PC
Practice addresses (Care Compare)
115 Spencer St
Winsted, CT 06098-1140
Phone (860) 738-5814
14 Jones Hollow Rd
Marlborough, CT 06447-1448
Phone (860) 295-8217
950 Yale Ave
Wallingford, CT 06492-1858
Phone (203) 265-9600
Hospital & facility affiliations
- Hartford Healthcare at Home
- Middlesex Health Care at Home and Hospice Program
- Middlesex Health Care at Home & Hospice Program
- Middlesex Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 14 |
| Removal of skin lesions | 43 |
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040116000909 | CT | Practitioner - Family Practice | 3274434741 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018271 | CT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Physicians PC | Family Medicine | Current |
Accepting new patients |
Locations
4 Farm Springs Rd
Farmington, CT 06032
Phone (860) 284-5200
14 Jones Hollow Rd
Marlborough, CT 06447
Phone (860) 295-8217
115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810
Interoperability endpoints
- mark.tuttle.npi1194737130.phpct@direct.optumcare.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 018271 | CT | Yes |
Addresses
Primary practice location
14 Jones Hollow Rd
Marlborough, CT 06447-1448
Mailing address
4 Farm Springs Rd
Prohealth Physicians
Farmington, CT 06032-2573
Phone (860) 284-5200
Other providers in Marlborough, CT
- Vinsee Tang
- Lindsay Sarah Tarkington
- Thatcher'S Pharmcy Inc
- Total Balnce Center
- Candace Treadway
- Benedict Charles Valentine II
- Valley Physical Therapy & Sports Medicine Services, P.C.
- Valley Physical Therapy, LLC
- Allison Turner Villar
- Nancy Anne Visco
All providers in Marlborough, CT · Family Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.