NPIMap

Organization Active NPI

MHS Primary Care Inc

  • Family Medicine Physician
  • Essex, CT
National Provider Identifier
1215436894
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MHS PRIMARY CARE INC
Practice address
9 Wildwood Medical Ctr Unit 2
Essex, CT 06426-1155
Phone
(860) 358-3170
Fax
(860) 358-8666
NPI assigned
Feb 8, 2018
Last updated
Feb 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Authorized official

Name
Susan Martin
Title
Network Executive
Phone
(860) 358-4802

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

9 Wildwood Medical Ctr Unit 2
Essex, CT 06426-1155

Mailing address

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-4820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040202000945 CT Part B Supplier - Clinic/Group Practice 4082507371 Receives reassigned benefits from 218 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Middletown, CT; Moodus, CT; New Haven, CT; Old Saybrook, CT; Portland, CT; Westbrook, CT; Marlborough, CT; Madison, CT…

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
MHS Primary Care Inc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

520 Saybrook Rd
Ste N100
Middletown, CT 06457
Phone (860) 344-1801

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1215436894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-4820",
            "fax_number": "860-358-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 WILDWOOD MEDICAL CTR UNIT 2",
            "city": "ESSEX",
            "state": "CT",
            "postal_code": "064261155",
            "telephone_number": "860-358-3170",
            "fax_number": "860-358-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MHS PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-08",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "NETWORK EXECUTIVE",
        "authorized_official_telephone_number": "860-358-4802"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.