Active NPI
Manuel Anthony Moutinho IV, M.D.
- Surgery Physician
- Miami, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 55646
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
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
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
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55646 | CT | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group Specialists, PLLC | Surgery | Current | Accepting new patients |
| Trinity Health of New England Provider Network Organization Inc | Current | Accepting new patients | |
| Hartford Hospital | Current | Accepting new patients | |
| Hartford Healthcare Medical Group Specialists LLC | Current | Accepting new patients | |
| Trinity Health of New England Provider Network Organization Inc | Current | Accepting new patients | |
| Hartford Hospital | Surgery | Current | 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
- 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.
-
- Surgery Physician
- Hartford, CT
- NPI 1023584216
-
- Surgery Physician
- Hartford, CT
- NPI 1407806391
-
dba Trinity Health Of New England Medical Group
- Internal Medicine Physician
- Hartford, CT
- NPI 1003882812
-
- Customized Equipment (DME)
- Groton, CT
- NPI 1295367068
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1770696643
-
dba Trinity Health Of New England Medical Group
- Internal Medicine Physician
- Waterville, ME
- NPI 1134779531
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1770696643
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1902834880
-
- General Acute Care Hospital
- Norwich, CT
- NPI 1467517235
-
- General Acute Care Hospital
- Norwich, CT
- NPI 1639135718
-
- Psychiatric Hospital Unit
- Norwich, CT
- NPI 1730243536
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.