Individual provider Active NPI

Julia Maeve Hickey, DO

  • Family Medicine Physician
  • Putnam, CT
National Provider Identifier
1215623079
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
86649 Issued in CT
Practice address
202 Pomfret St
Putnam, CT 06260-1833
Phone
(860) 963-7917
Fax
(860) 963-0015
NPI assigned
Apr 14, 2023
Last updated
Oct 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 86649 CT Primary

Addresses

Primary practice location

202 Pomfret St
Putnam, CT 06260-1833

Mailing address

40 Mansfield Ave
Willimantic, CT 06226-2018
Phone (860) 450-7471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20230725001005 RI Order and Referring Only - Family PracticePractitioner - Family Practice 1456712355

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1215623079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262018",
            "telephone_number": "860-450-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601833",
            "telephone_number": "860-963-7917",
            "fax_number": "860-963-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "JULIA",
        "middle_name": "MAEVE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-14",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "86649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Putnam, CT

Sources for this page

Verify at the official NPI Registry.