Individual provider Active NPI

William R McQueen Jr., MD

  • Internal Medicine Physician
  • Southington, CT
National Provider Identifier
1376594531
Registry record updated Feb 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50535 Issued in CT
Practice address
55 Meriden Ave
Suite 1E
Southington, CT 06489-3238
Phone
(504) 842-4000
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13655R LA
Internal Medicine Physician 207R00000X 50535 CT Primary

Addresses

Primary practice location

55 Meriden Ave
Suite 1E
Southington, CT 06489-3238

Mailing address

55 Meriden Ave
Suite 1E
Southington, CT 06489-3238
Phone (504) 842-4000

Other identifiers 1

IdentifierTypeStateIssuer
1428752MedicaidLA

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
I20120801000000 CT Practitioner - Internal Medicine 9032004544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tulane University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians

Practice addresses (Care Compare)

21 S Rd
Farmington, CT 06032-2410
Phone (860) 284-5200

Hospital & facility affiliations

  • Uconn Health Community Network Home Health, Inc. Home health agency, Watertown, CT, CCN 077085
  • Elara Caring Home health agency, Rocky Hill, CT, CCN 077163
  • Saint Mary'S Hospital Hospital, Waterbury, CT, CCN 070016

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Past Accepting new patients

Locations

21 South Rd
Farmington, CT 06032
Phone (860) 679-4600

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

115 Waterbury Rd
Prospect, CT 06712
Phone (203) 758-5660

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: william.mcqueen.npi1376594531.phpct@direct.optumcare.masshiway.net

Organizations & group practices 2

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360281600000",
    "number": "1376594531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MERIDEN AVE",
            "address_2": "SUITE 1E",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064893238",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MERIDEN AVE",
            "address_2": "SUITE 1E",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064893238",
            "telephone_number": "504-842-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUEEN",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2013-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "13655R",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "50535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1428752",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

Verify at the official NPI Registry.