Individual provider Active NPI

Michael John Tiqui, M.D.

  • Emergency Medicine Physician
  • New Britain, CT
National Provider Identifier
1215165014
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
050746 Issued in CT
Practice address
100 Grand St
New Britain, CT 06052-2016
Phone
(860) 224-5771
NPI assigned
Jun 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301094887 MI
Emergency Medicine Physician 207P00000X 050746 CT Primary

Addresses

Primary practice location

100 Grand St
New Britain, CT 06052-2016

Mailing address

100 Grand St
New Britain, CT 06052-2016
Phone (860) 224-5771

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121003000270 CT Practitioner - Emergency Medicine 5991954166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Grand St
New Britain, CT 06052-2016
Phone (860) 224-6623

Hospital & facility affiliations

  • The Hospital of Central Connecticut Hospital, New Britain, CT, CCN 070035

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as group
Quality
83.66
Promoting interoperability
100
Improvement activities
40
Cost
66.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
050746CTMDEmergency Medicine Physician
4301094887MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley Current Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Apr 1, 2017 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Apr 1, 2017 Accepting new patients

Locations

100 Grand St
Ste E119
New Britain, CT 06052
Phone (860) 224-5305

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1215165014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GRAND ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060522016",
            "telephone_number": "860-224-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRAND ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060522016",
            "telephone_number": "860-224-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIQUI",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301094887",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "050746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Britain, CT

Sources for this page

Verify at the official NPI Registry.