Individual provider Active NPI

Theresa Marie Castillejo

  • Family Nurse Practitioner
  • West Hartford, CT
National Provider Identifier
1326757840
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11283 Issued in CT
Practice address
65 Memorial Rd Ste 508
West Hartford, CT 06107-4233
Phone
(860) 696-2925
NPI assigned
Nov 23, 2022
Last updated
Nov 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11283 CT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

65 Memorial Rd Ste 508
West Hartford, CT 06107-4233

Mailing address

65 Memorial Rd Ste 508
West Hartford, CT 06107-4233
Phone (860) 696-2925

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
I20230130002263 CT Practitioner - Nurse Practitioner 3476924432 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford HospitalGroup PAC ID 2567366016, shared by 6 NPIs, 1,040 clinicians
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

65 Memorial Rd
West Hartford, CT 06107-2434
Phone (860) 545-7330

65 Memorial Rd
Suite 508
West Hartford, CT 06107-4233
Phone (860) 696-2925

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
011283CTMDClinical Social Worker
11283CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Feb 1, 2023 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Feb 1, 2023 Accepting new patients
Hartford Hospital CurrentSince Feb 1, 2023 Accepting new patients
Hartford Hospital CurrentSince Feb 1, 2023 Accepting new patients

Locations

280 S Main St
Ste 103
Cheshire, CT 06410

100 Perkins Farm Dr
Ste 303
Mystic, CT 06355
Phone (860) 886-1433

1 Towne Park Plz
Norwich, CT 06360
Phone (860) 886-1433

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

65 Memorial Rd
West Hartford, CT 06107
Phone (860) 231-1707

65 Memorial Rd
Ste 410
West Hartford, CT 06107
Phone (860) 368-1648

65 Memorial Rd
Ste 508
West Hartford, CT 06107

300 Post Rd W
Ste 102
Westport, CT 06880
Phone (203) 332-3272

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: theresa.castillejo@xdr.hhchealthdirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1326757840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 MEMORIAL RD STE 508",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061074233",
            "telephone_number": "860-696-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MEMORIAL RD STE 508",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061074233",
            "telephone_number": "860-696-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLEJO",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "11283",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.