Shelley Burchsted, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

56065 Issued in CT

Practice address

90 S Main St
Family Residency Program
Middletown, CT 06457-3649

Phone

(860) 358-6300

Fax

(860) 358-9249

NPI assigned

Jul 5, 2013

Last updated

Aug 11, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

University of Connecticut School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MHS Primary Care, Inc.Group PAC ID 4082507371, 180 clinicians

Middlesex HospitalGroup PAC ID 5092611731, shared by 7 NPIs, 231 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Middlesex Health Care at Home and Hospice Program Home health agency, Middletown, CT, CCN 077086
• Middlesex Health Care at Home & Hospice Program Hospice, Middletown, CT, CCN 071522
• Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sburchsted9913@middlesexhealthprd.direct-ci.com

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.

• MHS Primary Care, Inc

  • Family Medicine Physician
  • Middletown, CT
  • NPI 1336279058
  Medicare reassignment Care Compare group NPD
• Middlesex Hospital

  dba Middlesex Hospital dba Family Practice Group

  • Family Medicine Physician
  • Middletown, CT
  • NPI 1851350664
  Medicare reassignment NPD
• Middlesex Hospital

  dba Middlesex Hospital dba Middlesex Hospital Physician Services

  • Family Nurse Practitioner
  • Middletown, CT
  • NPI 1972563138

  Family Medicine

  Medicare reassignment NPD
• Connecticut Pathology Group PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Middletown, CT
  • NPI 1740219625
  NPD
• MHS Primary Care Inc

  dba Middlesex Health Concierge Medicine

  • Internal Medicine Physician
  • Essex, CT
  • NPI 1750276655

  Family Medicine

  NPD
• Middlesex Hospital

  dba Middlesex Hospital Homecare and Hospice

  • Community Based Hospice Care Agency
  • Middletown, CT
  • NPI 1003873233

  Family Medicine

  NPD
• Middlesex Hospital

  dba Middlesex Hospital dba Middlesex Hospital Psychiatric Physician Servic

  • Psychiatry Physician
  • Middletown, CT
  • NPI 1760451041
  NPD
• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  NPD

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

• Middlesex Hospital

  dba Middlesex Hospital Homecare

  • Home Health Agency
  • Middletown, CT
  • NPI 1194781328
  Care Compare affiliation Name & address match
• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  Care Compare affiliation

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502409600000",
    "number": "1235579251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 S MAIN ST",
            "address_2": "FAMILY RESIDENCY PROGRAM",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573649",
            "telephone_number": "860-358-6300",
            "fax_number": "860-358-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 S MAIN ST",
            "address_2": "FAMILY RESIDENCY PROGRAM",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573649",
            "telephone_number": "860-358-6300",
            "fax_number": "860-358-9249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCHSTED",
        "first_name": "SHELLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-05",
        "last_updated": "2017-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "56065",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "56065",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST LIC",
            "identifier": "56065",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel J Bryant, MSED, LPC
• Alec William Buchanan, PHD MD
• Building Connections Counseling & Wellness Group, LLC.
• Theresa Burak
• Mary Louise Burbank, RD
• Burgess Health Associates, LLC (HealthTrac)
• Burgess Health Associates, LLC (HealthTrac)
• Darlene Marie Burlock, RN
• Craig Gazland Burns, MD
• Jennifer Araujo Burns, APRN

• Family Medicine Physician in Middletown, CT
• Providers in Middletown, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.