Organization Active NPI

Quinones Medical Group LLC

  • Internal Medicine Physician
  • West Hartford, CT
National Provider Identifier
1275654162
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
044164 Issued in CT
Legal business name
QUINONES MEDICAL GROUP LLC
Practice address
1007 Farmington Ave
Suite 3a
West Hartford, CT 06107
Phone
(860) 570-4882
Fax
(860) 570-4885
NPI assigned
Apr 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Authorized official

Name
Maria E Quinones, MDNPI 1164567434
Title
Owner
Phone
(860) 570-4882

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 044164 CT Primary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X 002324 CT

Addresses

Primary practice location

1007 Farmington Ave
Suite 3a
West Hartford, CT 06107

Mailing address

1007 Farmington Ave
Suite 3a
West Hartford, CT 06107-2133
Phone (860) 570-4882

Other identifiers 2

IdentifierTypeStateIssuer
004269991MedicaidCT
004269983MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070627000443 CT Part B Supplier - Clinic/Group Practice 2860591138 Receives reassigned benefits from 1 practitioner
Practice locations: West Hartford, CT

National Provider Directory

National Provider Directory

Locations

342 N Main St
Ste 310
West Hartford, CT 06117
Phone (860) 570-4882

1007 Farmington Ave
Ste 3A
West Hartford, CT 06107
Phone (860) 570-4882

1007 Farmington Ave
Ste 2
West Hartfrd, CT 06107
Phone (860) 232-2900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528675200000",
    "number": "1275654162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 FARMINGTON AVE",
            "address_2": "SUITE 3A",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072133",
            "telephone_number": "860-570-4882",
            "fax_number": "860-570-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 FARMINGTON AVE",
            "address_2": "SUITE 3A",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "06107",
            "telephone_number": "860-570-4882",
            "fax_number": "860-570-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUINONES MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2018-06-11",
        "status": "A",
        "authorized_official_last_name": "QUINONES",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-570-4882",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "044164",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "002324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004269991",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004269983",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.