Active NPI
Trevor Donnelly Poplewko, MD
- Student in an Organized Health Care Education/Training Program
- Manchester, CT
National Provider Identifier
1306578299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 130 Hartford Rd
Manchester, CT 06040-5921 - Phone
- (860) 533-4679
- Fax
- (860) 645-4151
- NPI assigned
- Jun 29, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | CT | Primary |
Addresses
Primary practice location
130 Hartford Rd
Manchester, CT 06040-5921
Mailing address
71 Haynes St
Manchester, CT 06040-4188
Phone (860) 533-4679
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220708002265 | GA | Order and Referring Only - Pediatric Medicine | 0244610186 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777593600000",
"number": "1306578299",
"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": "060404188",
"telephone_number": "860-533-4679",
"fax_number": "860-645-4151"
},
{
"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",
"fax_number": "860-645-4151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPLEWKO",
"first_name": "TREVOR",
"middle_name": "DONNELLY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-29",
"last_updated": "2026-05-01",
"certification_date": "2026-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CT",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Manchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.