Individual provider Active NPI

Marlene Shute, M.D.

  • Internal Medicine Physician
  • Milford, CT
National Provider Identifier
1245552306
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
267454-1 Issued in NY
Practice address
40 Commerce Park Ste 1
Milford, CT 06460
Phone
(203) 878-3531
Fax
(866) 284-6188
NPI assigned
Feb 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 267454-1 NY Primary

Addresses

Primary practice location

40 Commerce Park Ste 1
Milford, CT 06460

Mailing address

40 Commerce Park Ste 1
Milford, CT 06460-3535
Phone (203) 878-3531

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
I20150203000023 CT Practitioner - Internal Medicine 7214169655 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
267454-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine of Milford, P.C. Internal Medicine CurrentSince Mar 12, 2018 Accepting new patients

Locations

40 Commerce Park
Milford, CT 06460
Phone (203) 878-3531

40 Commerce Park
Ste 1
Milford, CT 06460
Phone (203) 878-3531

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AJBDAA

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1245552306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 COMMERCE PARK STE 1",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603535",
            "telephone_number": "203-878-3531",
            "fax_number": "866-284-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 COMMERCE PARK STE 1",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "06460",
            "telephone_number": "203-878-3531",
            "fax_number": "866-284-6188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTE",
        "first_name": "MARLENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-17",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "267454-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.