Individual provider Active NPI

Alexandra Zacchera

  • Family Medicine Physician
  • Manchester, CT
National Provider Identifier
1306208327
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
61996 Issued in CT
Practice address
130 Hartford Rd
Manchester, CT 06040-5921
Phone
(860) 533-4679
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 61996 CT Primary

Addresses

Primary practice location

130 Hartford Rd
Manchester, CT 06040-5921

Mailing address

71 Haynes St
Manchester, CT 06040-4131

Other names 1

  • Alexandra Remus Former name

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
I20190723000199 CT Practitioner - Family Practice 7911233465 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Connecticut LLCGroup PAC ID 8628104072, 36 clinicians

Practice addresses (Care Compare)

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 646-1222

Hospital & facility affiliations

  • Hartford Healthcare at Home Hospice, East Hartford, CT, CCN 071507
  • Manchester Memorial Hospital Hospital, Manchester, CT, CCN 070027
  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61996CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Connecticut, LLC Family Medicine CurrentSince Jul 1, 2019 Accepting new patients
Sound Physicians of Massachusetts II PC CurrentSince Apr 1, 2022 Accepting new patients

Locations

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

Organizations & group practices 2

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1306208327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131"
        },
        {
            "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": "860-533-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACCHERA",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "61996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "REMUS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.