Individual provider Active NPI

Veronica Rolim Sales Fernandes, MD

  • Internal Medicine Physician
  • Stratford, CT
National Provider Identifier
1376706333
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
57045 Issued in CT
Practice address
2890 Main St Ste 2a
Stratford, CT 06614-4980
Phone
(203) 378-3696
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57045 CT Primary

Addresses

Primary practice location

2890 Main St Ste 2a
Stratford, CT 06614-4980

Mailing address

2890 Main St Ste 2a
Stratford, CT 06614-4980
Phone (203) 378-3696

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
I20171117002560 CT Practitioner - Internal Medicine 1456617828 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57045CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health, Inc. Internal Medicine CurrentSince Dec 1, 2017 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Dec 1, 2020 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

2660 Main St
Ste 216
Bridgeport, CT 06606
Phone (203) 335-0919

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

2890 Main St
Ste 2A
Stratford, CT 06614
Phone (203) 378-3696

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1376706333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 MAIN ST STE 2A",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144980",
            "telephone_number": "203-378-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 MAIN ST STE 2A",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144980",
            "telephone_number": "203-378-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "VERONICA",
        "middle_name": "ROLIM SALES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "57045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, CT

Sources for this page

Verify at the official NPI Registry.