NPIMap

Individual provider Active NPI

Maria L. Moro-de-Casillas, MD

  • Neurology Physician
  • Mystic, CT
National Provider Identifier
1255358230
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD11991 Issued in RI
Practice address
100 Perkins Farm Drive
Suite 103
Mystic, CT 06355
Phone
(860) 870-6385
Fax
(860) 245-0000
NPI assigned
Jul 16, 2006
Last updated
Jul 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 44391 CT
Neurology Physician 2084N0400X MD11991 RI Primary

Addresses

Primary practice location

100 Perkins Farm Drive
Suite 103
Mystic, CT 06355

Mailing address

100 Perkins Farm Drive
Suite 103
Mystic, CT 06355
Phone (860) 886-1433

Other practice location 1

35 Talcottville Rd Ste 6
Vernon, CT 06066-5261
Phone (860) 870-6385

Other identifiers 1

IdentifierTypeStateIssuer
001443910MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061026000426 CT Practitioner - Neurology 0345247706 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians
Hartford HospitalGroup PAC ID 2567366016, shared by 6 NPIs, 1,040 clinicians

Practice addresses (Care Compare)

584 Norwich Rd
Suite 400
Plainfield, CT 06374-1727
Phone (860) 564-9240

80 Seymour St
Hartford, CT 06102-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44391CTMDNeurology Physician
MD11991RIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Neurology CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group, Inc Neurology CurrentSince Jul 2, 2018 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients
Hartford Hospital Neurology CurrentSince Oct 7, 2020 Accepting new patients
The William W Backus Hospital Current Accepting new patients
The William W Backus Hospital CurrentSince Apr 20, 2015 Accepting new patients
William W Backus Hospital CurrentSince Apr 20, 2015 Accepting new patients
Hartford Hospital CurrentSince Oct 7, 2020 Accepting new patients

Locations

100 Perkins Farm Dr
Ste 102
Mystic, CT 06355
Phone (860) 870-6385

100 Perkins Farm Dr
Ste 103
Mystic, CT 06355
Phone (860) 870-6385

1 Towne Park Plz
Norwich, CT 06360
Phone (860) 886-1433

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

584 Norwich Rd
Ste 400
Plainfield, CT 06374
Phone (860) 455-3945

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

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

35 Talcottville Rd
Ste 6
Vernon, CT 06066
Phone (860) 870-6385

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

Interoperability endpoints

  • Direct secure messaging: maria.moro-de-casillas@xdr.hhchealthdirect.org

Organizations & group practices 8

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 8

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1255358230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PERKINS FARM DRIVE",
            "address_2": "SUITE 103",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-886-1433",
            "fax_number": "860-886-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PERKINS FARM DRIVE",
            "address_2": "SUITE 103",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-870-6385",
            "fax_number": "860-245-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Talcottville Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Vernon",
            "state": "CT",
            "postal_code": "060665261",
            "country_code": "US",
            "telephone_number": "860-870-6385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORO-DE-CASILLAS",
        "first_name": "MARIA",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "44391",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "RI",
            "license": "MD11991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001443910",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mystic, CT

Sources for this page

Verify at the official NPI Registry.