NPIMap

Individual provider Active NPI

Todd B Sheridan, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Hartford, CT
National Provider Identifier
1336199546
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
67636 Issued in CT
Practice address
80 Seymour St
Hartford, CT 06102
Phone
(860) 972-6113
NPI assigned
May 10, 2006
Last updated
Jun 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CT
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 67636 CT Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X D0064256 MD

Addresses

Primary practice location

80 Seymour St
Hartford, CT 06102

Mailing address

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 972-6113

Other practice location 1

6305 Ivy Ln Ste 100
Greenbelt, MD 20770-6323
Phone (844) 522-4263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210615000251 CT Practitioner - Pathology 4880606425 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Medical College of Ohio, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Pathology Associates PCGroup PAC ID 8729989561, 29 clinicians

Practice addresses (Care Compare)

80 Seymour St
Pathology Dept
Hartford, CT 06141-0540
Phone (860) 545-2249

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
67636CTMDAnatomic Pathology & Clinical Pathology Physician
D0064256MDMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Pathology Associates, P.C. Anatomic Pathology & Clinical Pathology CurrentSince Jun 1, 2021 Accepting new patients
Hartford Hospital Current Accepting new patients
Physicians for Women's Health LLC Anatomic Pathology & Clinical Pathology CurrentSince Nov 1, 2023 Accepting new patients
Integrated Cellular and Molecular Diagnostics LLC Past Accepting new patients

Locations

103 Newtown Rd
Danbury, CT 06810
Phone (203) 730-8789

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

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 7

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1336199546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061028000",
            "telephone_number": "860-972-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06102",
            "telephone_number": "860-972-6113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6305 Ivy Ln Ste 100",
            "address_purpose": "LOCATION",
            "city": "Greenbelt",
            "state": "MD",
            "postal_code": "207706323",
            "country_code": "US",
            "telephone_number": "844-522-4263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "TODD",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CT",
            "license": "67636",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MD",
            "license": "D0064256",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.