Gregory Michael Ricketts

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

67612 Issued in CT

Practice address

1625 Straits Tpke Ste 200
Middlebury, CT 06762-1836

Phone

(203) 568-2929

Fax

(203) 575-5121

NPI assigned

May 12, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

General Surgery

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uconn Health Community Network Home Health, Inc. Home health agency, Watertown, CT, CCN 077085
• Waterbury Hospital Hospital, Waterbury, CT, CCN 070005

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gregoryricketts@amggw.allscriptsdirect.net

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.

• Prospect CT Medical Foundation, Inc.

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1144677568

  Surgery

  Medicare reassignment Care Compare group NPD
• Alliance Medical Group, Inc

  • Internal Medicine Physician
  • Middlebury, CT
  • NPI 1316273071

  Surgery

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prospect Waterbury Home Health, Inc.

  dba VNA Health at Home

  • Home Health Agency
  • Watertown, CT
  • NPI 1265880413
  Care Compare affiliation
• Prospect Waterbury, Inc.

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1477902641
  Care Compare affiliation

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1326459454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 ROBBINS ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082613",
            "telephone_number": "203-573-6162",
            "fax_number": "203-573-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TPKE STE 200",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-568-2929",
            "fax_number": "203-575-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "GREGORY",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-12",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "67612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariel Reid, APRN
• Resilient Raza Psychiatry PLLC
• Mira Rho, MD
• Richard N. Smith, DDS, PC
• Joshua Thomas Rickards, PA-C
• Caroline Jane Ricupero, DPT
• Raymond Michael Rinaldi, D.M.D.
• Kimberly A Rinko, LCSW,MSW,BA
• Karla A. Rios, LPC-A
• Rizza Chiropractic and Wellness, LLC

• Surgery Physician in Middlebury, CT
• Providers in Middlebury, CT by specialty
• Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.