Individual provider Active NPI

Samantha Alyssa Pelow, APRN

  • Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1215200654
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
004957 Issued in CT
Practice address
282 Washington St
Hartford, CT 06106-3322
Phone
(860) 545-9520
Fax
(860) 545-9545
NPI assigned
Feb 15, 2012
Last updated
Sep 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 004957 CT Primary
Family Nurse Practitioner 363LF0000X 337171 NY
Family Nurse Practitioner 363LF0000X 004957 CT

Addresses

Primary practice location

282 Washington St
Hartford, CT 06106-3322

Mailing address

P.O. Box 415933
Hartford Hospital Professional Services
Boston, MA 02241-5933
Phone (860) 545-7602

Other practice location 1

80 Seymour St
Hartford Hospital Surgery Dept
Hartford, CT 06102-5037
Phone (860) 545-2840

Other identifiers 1

IdentifierTypeStateIssuer
004049573MedicaidCT

Other names 1

  • Samantha Alyssa Thomas Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spelow18534@connecticutchildrens.direct-ci.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120904000061 CT Practitioner - Nurse Practitioner 2769639376 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

85 Seymour St
Suite 415
Hartford, CT 06106-5523
Phone (860) 246-2071

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
337171NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Nurse Practitioner CurrentSince Apr 1, 2022 Accepting new patients
Hartford Healthcare Medical Group, Inc Nurse Practitioner CurrentSince Jan 1, 2017 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Apr 1, 2022 Accepting new patients
Hartford Hospital CurrentSince Apr 3, 2012 Accepting new patients
Connecticut Children's Specialty Group, Inc. CurrentSince Feb 1, 2016 Accepting new patients
Connecticut Children's Specialty Group, Inc. CurrentSince Feb 1, 2016 Accepting new patients
Hartford Hospital CurrentSince Apr 3, 2012 Accepting new patients
Connecticut Children's Medical Center Past Accepting new patients

Locations

339 W Main St
Avon, CT 06001
Phone (860) 696-2150

105 Newtown Rd
#A
Danbury, CT 06810
Phone (860) 545-9395

399 Farmington Ave
Farmington, CT 06032
Phone 2032372477222

505 Farmington Ave
Farmington, CT 06032
Phone (860) 837-6700

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

282 Washington St
Ste 1H
Hartford, CT 06106
Phone (860) 545-8643

85 Seymour St
Ste 415
Hartford, CT 06106
Phone (860) 249-2071

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1281 E Main St
Ste 3
Stamford, CT 06902
Phone (860) 545-9200

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

191 Post Rd W
#1
Westport, CT 06880

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: samantha.pelow@xdr.hhchealthdirect.org

Organizations & group practices 8

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.

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": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1215200654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 415933",
            "address_2": "HARTFORD HOSPITAL PROFESSIONAL SERVICES",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415933",
            "telephone_number": "860-545-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322",
            "telephone_number": "860-545-9520",
            "fax_number": "860-545-9545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Seymour St",
            "address_2": "Hartford Hospital Surgery Dept",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061025037",
            "country_code": "US",
            "telephone_number": "860-545-2840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELOW",
        "first_name": "SAMANTHA",
        "middle_name": "ALYSSA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-15",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "004957",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337171",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "004957",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004049573",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spelow18534@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "THOMAS",
            "middle_name": "ALYSSA",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.