Individual provider Active NPI

Diamond Tyrell-Smith

  • Family Medicine Physician
  • Manchester, CT
National Provider Identifier
1346745395
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
048167788 Issued in CT
Practice address
130 Hartford Rd
Manchester, CT 06040-5921
Phone
(860) 538-8942
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 048167788 CT Primary

Addresses

Primary practice location

130 Hartford Rd
Manchester, CT 06040-5921

Mailing address

858 New Britain Ave
Hartford, CT 06106-3919
Phone (860) 538-8942

Other practice location 1

858 New Britain Ave
Hartford, CT 06106-3919
Phone (860) 538-8942

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210625001105 CT Practitioner - Family Practice 8224439450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Starling Physicians, PLLCGroup PAC ID 7517863749, 276 clinicians

Practice addresses (Care Compare)

580 Farmington Ave
Hartford, CT 06105-3077
Phone (860) 527-7255

Hospital & facility affiliations

  • Elara Caring Home health agency, Rocky Hill, CT, CCN 077163
  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
048167788CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Starling Physicians, PLLC CurrentSince Jul 1, 2021 Accepting new patients
Starling Physicians PLLC CurrentSince Jul 1, 2021 Accepting new patients
Starling Physicians, PLLC Past Accepting new patients
Starling Physicians, PLLC Past Accepting new patients

Locations

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

580 Farmington Ave
Hartford, CT 06105
Phone (860) 233-2222

2110 Silas Deane Hwy
Rocky Hill, CT 06067

Interoperability endpoints

  • Direct secure messaging: diamond.tyrell-smith@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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1346745395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "858 NEW BRITAIN AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063919",
            "telephone_number": "860-538-8942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HARTFORD RD",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405921",
            "telephone_number": "860-538-8942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "858 New Britain Ave",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063919",
            "country_code": "US",
            "telephone_number": "860-538-8942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYRELL-SMITH",
        "first_name": "DIAMOND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "048167788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.