Millicent M Malcolm, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

002258 Issued in CT

Practice address

520 Saybrook Rd
Suite N100
Middletown, CT 06457-4700

Phone

(860) 344-1801

Fax

(860) 358-8657

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

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

Practice addresses (Care Compare)

Hospital & facility affiliations

• Middlesex Health Care at Home and Hospice Program Home health agency, Middletown, CT, CCN 077086
• Enliven Home Health Home health agency, Rocky Hill, CT, CCN 077237
• Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmalcolm9654@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 and National Provider Directory roles.

• MHS Primary Care, Inc

  • Family Medicine Physician
  • Middletown, CT
  • NPI 1336279058
  Medicare reassignment Care Compare group NPD
• Millicent M Malcolm LLC

  • Nurse Practitioner
  • Middlefield, CT
  • NPI 1811037690
  NPD (past) Authorized official
• Matthew Raider MD LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Middletown, CT
  • NPI 1093952194
  NPD (past)
• Portland Care and Rehabilitation Centre

  • Skilled Nursing Facility
  • Portland, CT
  • NPI 1003947177
  NPD (past)
• Twin Maples Health Care Facility

  • Skilled Nursing Facility
  • Durham, CT
  • NPI 1851437743
  NPD (past)

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

• Middlesex Hospital

  • Home Health Agency
  • Middletown, CT
  • NPI 1194781328
  Care Compare affiliation Name & address match
• L Lofgren Inc.

  • Home Health Agency
  • Rocky Hill, CT
  • NPI 1710033741
  Care Compare affiliation
• 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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1255418414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-4820",
            "fax_number": "860-358-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SAYBROOK RD",
            "address_2": "SUITE N100",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574700",
            "telephone_number": "860-344-1801",
            "fax_number": "860-358-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCOLM",
        "first_name": "MILLICENT",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "002258",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "002258",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "002258",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4208296",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004208296",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Elizabeth Magnano, LCSW
• Halevoor B Mahalingaiah, MD
• Shannon Maher, M.D.
• Grace Majewski, MS, BCBA, LBA
• Theron Warren Malcher, DDS
• Carlton L Malloy, MSW,CAC,LADC,CCDP-D
• Andrea Marie Malon, M.D.
• Katherine Clare Maloney
• Man-Up Counseling and Mentoring Centers LLC
• Cristina Elizabeth Mancini, MD

• Nurse Practitioner in Middletown, CT
• Providers in Middletown, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.