Individual provider Active NPI

Michael Coyle

  • Psychologist
  • Putnam, CT
National Provider Identifier
1316044738
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
103T00000X Issued in CT
Practice address
5 A Sunset Avenue
Putnam, CT 06260
Phone
(860) 928-2119
Fax
(860) 928-4079
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 103T00000X CT Primary

Addresses

Primary practice location

5 A Sunset Avenue
Putnam, CT 06260

Mailing address

PO Box 158
Woodstock, CT 06281-0158
Phone (860) 928-2119

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051219000455 CT Practitioner - Clinical Psychologist 1951322940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coyle Psychological Associates LLCGroup PAC ID 0244251270, 2 clinicians

Practice addresses (Care Compare)

123 Broadway
Milford, CT 06460-5950
Phone (860) 942-1561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103T00000XCTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Coyle Psychological Associates LLC Psychologist CurrentSince Dec 23, 2005 Accepting new patients
Psych Associates New England Psychologist Past Accepting new patients

Locations

5A Sunset Ave
Putnam, CT 06260
Phone (203) 449-4017

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316044738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "WOODSTOCK",
            "state": "CT",
            "postal_code": "062810158",
            "telephone_number": "860-928-2119",
            "fax_number": "860-928-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 A SUNSET AVENUE",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "06260",
            "telephone_number": "860-928-2119",
            "fax_number": "860-928-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "103T00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Putnam, CT

Sources for this page

Verify at the official NPI Registry.