NPIMap

Organization Active NPI

Hartford Healthcare Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Meriden, CT
National Provider Identifier
1336491752
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
HARTFORD HEALTHCARE MEDICAL GROUP, INC
Practice address
455 Lewis Ave
Ste. 210
Meriden, CT 06451-2121
Phone
(203) 238-1241
NPI assigned
Oct 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Authorized official

Name
Mark Bancroft Vye
Title
VP Administration
Phone
(860) 972-7858

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

455 Lewis Ave
Ste. 210
Meriden, CT 06451-2121

Mailing address

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 972-7040

National Provider Directory

National Provider Directory
Tax ID family
Hartford Healthcare Medical Group Specialists PLLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1336491752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "860-972-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 LEWIS AVE",
            "address_2": "STE. 210",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512121",
            "telephone_number": "203-238-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARTFORD HEALTHCARE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-09",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "VYE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "BANCROFT",
        "authorized_official_title_or_position": "VP ADMINISTRATION",
        "authorized_official_telephone_number": "860-972-7858"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.