Individual provider Active NPI

Marc L. Guttman, M.D.

  • Emergency Medicine Physician
  • Willimantic, CT
National Provider Identifier
1295709186
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
041783 Issued in CT
Practice address
112 Mansfield Ave
Willimantic, CT 06226-2045
Phone
(860) 456-9116
Fax
(860) 963-6368
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 041783 CT Primary

Addresses

Primary practice location

112 Mansfield Ave
Willimantic, CT 06226-2045

Mailing address

202 Grassy Hill Rd
East Lyme, CT 06333-1012
Phone (860) 691-0328

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051228000369 CT Practitioner - Emergency Medicine 9638144074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of Ny Upstate Medical University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The William W Backus HospitalGroup PAC ID 0749170645, 248 clinicians

Practice addresses (Care Compare)

326 Washington St
Inpatien Psych
Norwich, CT 06360-2740
Phone (860) 889-8331

Hospital & facility affiliations

  • William W Backus Hospital Hospital, Norwich, CT, CCN 070024

Merit-based Incentive Payment System (MIPS)

Final score
97.8 of 100Reported as group
Quality
90
Promoting interoperability
100
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
041783CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William W Backus Hospital CurrentSince Jan 1, 2007 Accepting new patients
The William W Backus Hospital Current Accepting new patients
Usacs of Connecticut, LLC Emergency Medicine Past Accepting new patients

Locations

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1295709186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 GRASSY HILL RD",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331012",
            "telephone_number": "860-691-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262045",
            "telephone_number": "860-456-9116",
            "fax_number": "860-963-6368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTTMAN",
        "first_name": "MARC",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "041783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.