Individual provider Active NPI

Maria C Clement, APRN

  • Family Nurse Practitioner
  • Farmington, CT
National Provider Identifier
1275800070
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
004831 Issued in CT
Practice address
263 Farmington Ave
Occupational Medicine
Farmington, CT 06030-6210
Phone
(860) 679-2893
Fax
(860) 679-4587
NPI assigned
Nov 22, 2011
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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 004831 CT Primary

Addresses

Primary practice location

263 Farmington Ave
Occupational Medicine
Farmington, CT 06030-6210

Mailing address

28 Glenview Dr
Kensington, CT 06037-1142
Phone (860) 829-2002

Other identifiers 1

IdentifierTypeStateIssuer
1275800070MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mclement10696@direct.med.uchc.edu

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
I20120307000797 CT Practitioner - Nurse Practitioner 8325207533 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
004831CTMDGeneral Practice Dentistry
4831CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Feb 14, 2012 Accepting new patients
University of Connecticut Health Center CurrentSince Feb 14, 2012 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

Interoperability endpoints

  • Direct secure messaging: mclement10696@direct.med.uchc.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1275800070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 GLENVIEW DR",
            "city": "KENSINGTON",
            "state": "CT",
            "postal_code": "060371142",
            "telephone_number": "860-829-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "OCCUPATIONAL MEDICINE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060306210",
            "telephone_number": "860-679-2893",
            "fax_number": "860-679-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENT",
        "first_name": "MARIA",
        "middle_name": "C",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-22",
        "last_updated": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "004831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275800070",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mclement10696@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "Uconn Medical Group",
            "address_2": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.