Individual provider Active NPI

Nicole Tittarelli, PA

  • Physician Assistant
  • Hartford, CT
National Provider Identifier
1316406333
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
114 Woodland St
Hartford, CT 06105-1208
Phone
(860) 714-4694
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

114 Woodland St
Hartford, CT 06105-1208

Mailing address

114 Woodland St
Hartford, CT 06105-1208

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190605000633 CT Practitioner - Physician Assistant 5698008712 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Medical Associates, LLCGroup PAC ID 7214107515, 113 clinicians

Practice addresses (Care Compare)

1040 Barnum Ave
Stratford, CT 06614-4968
Phone (860) 650-3848

1226 S Broad St
Wallingford, CT 06492-1715
Phone (860) 650-3848

2165 Dixwell Ave
Hamden, CT 06514-2116
Phone (860) 650-3848

236 Boston Post Rd
Orange, CT 06477-3236
Phone (860) 650-3848

607 W Main St
Norwich, CT 06360-6056
Phone (860) 650-3848

78 Pershing Dr
Derby, CT 06418-1433
Phone (860) 650-3848

900 Main St S
Suite 100
Southbury, CT 06488-4213
Phone (860) 650-3848

Hospital & facility affiliations

  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Nov 9, 2020 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jun 17, 2019 Accepting new patients
WRK Ventures, LLC Past Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

Interoperability endpoints

  • Direct secure messaging: ntittarelli655907@direct.ynhh.org

Organizations & group practices 8

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 2

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1316406333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITTARELLI",
        "first_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.