Manuel A. Orta Cobo, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

56881 Issued in CT

Practice address

55 Nye Rd Ste 105
Glastonbury, CT 06033-1281

Phone

(860) 375-5088

Fax

(860) 590-2030

NPI assigned

Jun 28, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23873/brand/1/csg/1/fhir/r4
• Direct secure messaging: manuel.orta@fhpediatrics.eclinicaldirectplus.com

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.

• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  Pediatrics

  Medicare reassignment NPD
• Fig Health Pediatrics LLC

  • Pediatrics Physician
  • Glastonbury, CT
  • NPI 1457020216
  NPD Authorized official
• South Windsor Pediatrics, LLC

  • Pediatric Adolescent Medicine Physician
  • South Windsor, CT
  • NPI 1851588701
  NPD (past)

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1346504941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 994",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060330994",
            "telephone_number": "860-375-5088",
            "fax_number": "860-590-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NYE RD STE 105",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331281",
            "telephone_number": "860-375-5088",
            "fax_number": "860-590-2030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1665 Ellington Rd",
            "address_purpose": "LOCATION",
            "city": "South Windsor",
            "state": "CT",
            "postal_code": "060742705",
            "country_code": "US",
            "telephone_number": "860-648-2447",
            "fax_number": "860-644-0874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5955 Ponce De Leon Blvd",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331462423",
            "country_code": "US",
            "telephone_number": "305-661-1515 x243",
            "fax_number": "305-662-3723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORTA COBO",
        "first_name": "MANUEL",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-28",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101253331",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME119697",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "14868",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "56881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010977100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christyn Marie Opromollo, PSYD
• Optimal Nutrition LLC
• Optimal Nutrition LLC
• Origin Counseling, LLC
• Kayla Marie Orozco
• Orthopaedic Sports Specialists, PC
• Orthopaedic Sports Specialists, PC
• Orthopedic Associates of Hartford,PC
• Orthopedic Associates of Hartford,PC
• Osteopathic Center of Glastonbury PLLC

• Pediatrics Physician in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Pediatrics Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.