Michael D Waddington, DO

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

53391 Issued in CT

Practice address

78 Eastern Blvd Ste 6
Glastonbury, CT 06033-4325

Phone

(860) 993-3516

Fax

(860) 430-6885

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2025 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Osteopathic Center of Glastonbury PLLC

  • Neuromusculoskeletal Medicine & OMM Physician
  • Glastonbury, CT
  • NPI 1487436929
  NPD Authorized official

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1205043486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 EASTERN BLVD STE 6",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334325",
            "telephone_number": "860-993-3516",
            "fax_number": "860-430-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 EASTERN BLVD STE 6",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334325",
            "telephone_number": "860-993-3516",
            "fax_number": "860-430-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDINGTON",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MI",
            "license": "5101016862",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CT",
            "license": "53391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vista Counseling Associates, LLC
• Vitalized Performance Group
• Vivo Chiropractic Glastonbury LLC
• Hannah Vollinger, AU.D.
• Katherine E Voss, PA-C
• Waylee Lane Wagoner
• Mandy A Wainscoat, DO
• Iqra Walayat
• Walgreen Co
• Walgreen Co

• Neuromusculoskeletal Medicine & OMM Physician in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.