Individual provider Active NPI

Faisal Ijaz, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • East Hartford, CT
National Provider Identifier
1336573146
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5497 Issued in CT
Practice address
580 Burnside Ave
East Hartford, CT 06108-3579
Phone
(860) 528-5068
Fax
(860) 528-2341
NPI assigned
Aug 28, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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 5497 CT Primary
Family Nurse Practitioner 363LF0000X RN2290444 MA

Addresses

Primary practice location

580 Burnside Ave
East Hartford, CT 06108-3579

Mailing address

24 Grimes Rd
Rocky Hill, CT 06067-2406
Phone (860) 597-1331

Other practice location 1

430 Cooley St
Springfield, MA 01128-1180
Phone (413) 782-0320

Other practice location 2

263 Farmington Avenue
Farmington, CT 06030-8082
Phone (860) 679-6599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140514000120 MA Practitioner - Nurse Practitioner 1355564675 Reassigns benefits to 3 organizations
I20150320000405 CT Practitioner - Nurse Practitioner 1355564675 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Medical Center LLCGroup PAC ID 0840570628, 52 clinicians

Practice addresses (Care Compare)

1505 Memorial Dr
Chicopee, MA 01020-3900
Phone (413) 366-9977

365 Hemingway Ave
East Haven, CT 06512-2384
Phone (860) 454-0678

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5497CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Massachusetts CurrentSince Oct 28, 2017 Accepting new patients
First Choice Health Centers, Inc. Current Accepting new patients
First Choice Health Centers, Inc. CurrentSince Aug 29, 2016 Accepting new patients
Afc Physicians of Connecticut, PC CurrentSince Aug 1, 2015 Accepting new patients
Starling Physicians PLLC CurrentSince Apr 1, 2019 Accepting new patients
First Choice Health Centers, Inc. CurrentSince Aug 29, 2016 Accepting new patients
Afc Physicians of Connecticut, PC CurrentSince Aug 1, 2015 Accepting new patients
Starling Physicians, PLLC CurrentSince Apr 1, 2019 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince May 1, 2017 Accepting new patients
Medexpress Urgent Care, PC - Massachusetts CurrentSince Oct 28, 2017 Accepting new patients
Infinite Medical PC CurrentSince Jul 30, 2023 Accepting new patients
Urgent Care Medical Center LLC CurrentSince Feb 10, 2023 Accepting new patients
State of Connecticut CurrentSince Feb 8, 2021 Accepting new patients
State of Connecticut CurrentSince Feb 8, 2021 Accepting new patients
University of Connecticut Health Center Past Accepting new patients
Mevelyn Michelle Morse DPM. PC PastSince Feb 10, 2023 Accepting new patients
Connecticut OBGYN Past Accepting new patients

Locations

100 Simsbury Rd
Avon, CT 06001
Phone (860) 659-8830

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

2 Main St
Danbury, CT 06810
Phone (203) 826-2140

265 Ellington Rd
East Hartford, CT 06108
Phone (860) 291-2789

365 Hemingway Ave
East Haven, CT 06512
Phone (203) 466-1410

105 West Rd
Ellington, CT 06029
Phone (860) 454-0678

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

94 Connecticut Blvd
Hartford, CT 06108
Phone (860) 610-6191

111 Salem Tpke
Ste 8
Norwich, CT 06360
Phone (860) 886-0023

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

80 Fern Dr
Torrington, CT 06790
Phone (203) 294-7300

1505 Memorial Dr
Chicopee, MA 01020
Phone (413) 331-4336

111 Headwaters Dr
Harwich, MA 02645
Phone (508) 430-1717

430 Cooley St
Springfield, MA 01128
Phone (413) 295-4144

250 Skillman St
Ste 202
Brooklyn, NY 11205

250 Skillman St
Ste 204
Brooklyn, NY 11205
Phone (513) 341-7173

Interoperability endpoints

  • Direct secure messaging: faisal.ijaz@xdr.hhchealthdirect.org

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1336573146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 GRIMES RD",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060672406",
            "telephone_number": "860-597-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 BURNSIDE AVE",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083579",
            "telephone_number": "860-528-5068",
            "fax_number": "860-528-2341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 Cooley St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011281180",
            "country_code": "US",
            "telephone_number": "413-782-0320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Farmington Avenue",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060308082",
            "country_code": "US",
            "telephone_number": "860-679-6599",
            "fax_number": "860-679-7077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IJAZ",
        "first_name": "FAISAL",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-28",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "5497",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2290444",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

Verify at the official NPI Registry.