NPIMap

Individual provider Active NPI

Erica Louise Waddington, D.O.

  • Family Medicine Physician
  • Manchester, CT
National Provider Identifier
1306159819
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
53552 Issued in CT
Practice address
130 Hartford Rd
Manchester, CT 06040-5921
Phone
(860) 533-4673
NPI assigned
Jul 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO00746 RI
Family Medicine Physician 207Q00000X 53552 CT Primary

Addresses

Primary practice location

130 Hartford Rd
Manchester, CT 06040-5921

Mailing address

130 Hartford Rd
Manchester, CT 06040-5921
Phone (860) 533-5673

Other names 1

  • Miss Erica Louise Jacobson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141021001929 CT Practitioner - Family Practice 0547438673 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Connecticut Health CenterGroup PAC ID 3678472016, 624 clinicians
Asylum Hill Family Medicine Center, Inc.Group PAC ID 9032016134, 24 clinicians

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3692

99 Woodland St
Hartford, CT 06105-1207
Phone (860) 714-4212

Hospital & facility affiliations

  • Elara Caring Home health agency, Rocky Hill, CT, CCN 077163
  • Hartford Healthcare at Home Home health agency, East Hartford, CT, CCN 077041
  • John Dempsey Hospital of the University of Connect Hospital, Farmington, CT, CCN 070036

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO00746RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Jun 22, 2018 Accepting new patients
University of Connecticut Health Center CurrentSince Jun 22, 2018 Accepting new patients
Asylum Hill Family Medicine Center Inc Family Medicine CurrentSince Apr 9, 2021 Accepting new patients
University of Connecticut Health Center Past Accepting new patients
Asylum Hill Family Medicine Center Inc Past Accepting new patients

Locations

117 Albany Tpke
Canton, CT 06019
Phone (860) 658-3444

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

99 Woodland St
Hartford, CT 06105
Phone (860) 714-4212

Interoperability endpoints

  • Direct secure messaging: ewaddington2387122@direct.trinity-health.org
  • Direct secure messaging: ewaddington30889@direct.med.uchc.edu

Organizations & group practices 5

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 4

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": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1306159819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HARTFORD RD",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405921",
            "telephone_number": "860-533-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HARTFORD RD",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405921",
            "telephone_number": "860-533-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDINGTON",
        "first_name": "ERICA",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "DO00746",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "53552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "JACOBSON",
            "middle_name": "LOUISE",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.