Individual provider Active NPI

Nicole Eddy Ortiz, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Uncasville, CT
National Provider Identifier
1245644954
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5728 Issued in CT
Practice address
80 Norwich New London Tpke
Uncasville, CT 06382-2527
Phone
(860) 848-1297
NPI assigned
Jun 20, 2014
Last updated
Jun 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5728 CT Primary

Addresses

Primary practice location

80 Norwich New London Tpke
Uncasville, CT 06382-2527

Mailing address

326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331

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
I20141020002008 CT Practitioner - Nurse Practitioner 0749401537 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The William W Backus HospitalGroup PAC ID 0749170645, 248 clinicians

Practice addresses (Care Compare)

326 Washington St
Inpatient Medical
Norwich, CT 06360-2740
Phone (860) 889-8331

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.8 of 100Reported as group
Quality
90
Promoting interoperability
100
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Sep 1, 2017 Accepting new patients
The William W Backus Hospital CurrentSince Dec 11, 2014 Accepting new patients
William W Backus Hospital CurrentSince Dec 11, 2014 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince Sep 1, 2022 Accepting new patients

Locations

194 Howard St
New London, CT 06320
Phone (860) 442-0564

111 Salem Tpke
Ste 8
Norwich, CT 06360
Phone (860) 886-0023

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

91 Voluntown Rd
Pawcatuck, CT 06379
Phone (860) 599-5477

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

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

80 Norwich New London Tpke
Uncasville, CT 06382
Phone (860) 425-8740

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

Interoperability endpoints

  • Direct secure messaging: nicole.ortiz@xdr.hhchealthdirect.org

Organizations & group practices 5

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 3

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": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1245644954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 WASHINGTON ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602740",
            "telephone_number": "860-889-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 NORWICH NEW LONDON TPKE",
            "city": "UNCASVILLE",
            "state": "CT",
            "postal_code": "063822527",
            "telephone_number": "860-848-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "NICOLE",
        "middle_name": "EDDY",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "5728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Uncasville, CT

Sources for this page

Verify at the official NPI Registry.