Individual provider Active NPI

Samantha Oldman

  • Registered Dietitian
  • Uncasville, CT
National Provider Identifier
1285005017
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1369 Issued in CT
Practice address
80 Norwich New London Tpke
Uncasville, CT 06382-2527
Phone
(860) 886-4337
NPI assigned
Oct 20, 2015
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1369 CT Primary

Addresses

Primary practice location

80 Norwich New London Tpke
Uncasville, CT 06382-2527

Mailing address

14 Webster CT
Newington, CT 06111-5119
Phone (860) 986-2261

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181101002412 CT Practitioner - Registered Dietitian Or Nutrition Professional 4688927098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
University of Connecticut School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

164 Otrobando Ave
Norwich, CT 06360-2116
Phone (860) 886-0012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1369CTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Nov 22, 2021 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Nov 22, 2021 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

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

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: soldman390961@xdr.hhchealthdirect.org

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": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1285005017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WEBSTER CT",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061115119",
            "telephone_number": "860-986-2261"
        },
        {
            "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": "860-886-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDMAN",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-20",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "1369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Uncasville, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.