Individual provider Active NPI

Manuel Anthony Moutinho IV, M.D.

  • Surgery Physician
  • Miami, FL
National Provider Identifier
1376838292
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
55646 Issued in CT
Practice address
1611 NW 12TH Ave
Miami, FL 33136
Phone
(860) 837-3018
NPI assigned
Jun 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 55646 CT Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136

Mailing address

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 837-3018

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmoutinho12227@direct.stfranciscare.org Direct

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
I20180802002345 CT Practitioner - General Surgery 4284939943 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
State University of New York Downstate Medical Center, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians
Hartford HospitalGroup PAC ID 2567366016, 1,040 clinicians

Practice addresses (Care Compare)

330 Washington St
Suite 420
Norwich, CT 06360-2700
Phone (860) 886-0660

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 545-7500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55646CTMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Surgery CurrentSince Apr 8, 2024 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Aug 1, 2018 Accepting new patients
Hartford Hospital CurrentSince Apr 1, 2025 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Apr 8, 2024 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Aug 1, 2018 Accepting new patients
Hartford Hospital Surgery CurrentSince Apr 1, 2025 Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

330 Washington St
Ste 420
Norwich, CT 06360
Phone (860) 886-0660

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

1000 Asylum Ave
Ste 4302
West Hartford, CT 06105
Phone (860) 714-4270

Interoperability endpoints

  • Direct secure messaging: mmoutinho526803@xdr.hhchealthdirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1376838292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-837-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33136",
            "telephone_number": "860-837-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUTINHO",
        "first_name": "MANUEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "55646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmoutinho12227@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1000 Asylum Ave Ste 4302",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061051704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.