Mary Elizabeth Barry, M.D.
Individual provider Active NPI Internal Medicine Physician · Willimantic, CT
NPI 1285695841 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1285695841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 25765 (CT)
- Practice address
- 14 Quarry St
Willimantic, CT 06226-1232 - Phone
- (860) 423-6733
- Fax
- (860) 450-1348
- NPI assigned
- Mar 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Owned or controlled facilities with NPI records 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| The William W Backus Hospital |
Hospital | Corporate Director | Jun 1, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091205000068 | CT | Practitioner - Internal Medicine | 6204733306 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25765 | CT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Windham Community Memorial Hospital, Inc. | Current |
Accepting new patients |
Locations
112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 25765 | CT | Yes |
Addresses
Primary practice location
14 Quarry St
Willimantic, CT 06226-1232
Mailing address
60 Fieldstone Dr
Mansfield, CT 06268-2572
Phone (860) 429-2599
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001257658 | Medicaid | CT |
Other providers in Willimantic, CT
- Carlita R Baldwin
- Erin Curry Bane
- Kassandrah Daniella Banks
- Vicki Lynn Barbero
- Kelli T Barbone
- Amy Bartlett
- Nicole Ann Bashar
- Burton T Bates
- Tyler C Beckwith
- Amy Rose Benenson
All providers in Willimantic, CT · Internal Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.