Individual provider Active NPI

Emily Vistica Sampino

  • Pediatrics Physician
  • Hartford, CT
National Provider Identifier
1386039808
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
61689 Issued in CT
Practice address
282 Washington St
Connecticut Children's Medical Center
Hartford, CT 06106-3322
Phone
(860) 545-9973
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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
Pediatrics Physician 208000000X 61689 CT Primary

Addresses

Primary practice location

282 Washington St
Connecticut Children's Medical Center
Hartford, CT 06106-3322

Mailing address

282 Washington St
Connecticut Children's Medical Center
Hartford, CT 06106-3322
Phone (860) 545-9973

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address evisticasampino16540@connecticutchildrens.direct-ci.com

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
I20220420003038 CT Practitioner - Pediatric Medicine 8123330636 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61689CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children's Specialty Group, Inc. Pediatrics CurrentSince May 1, 2022 Accepting new patients
Connecticut Children's Specialty Group, Inc. Pediatrics CurrentSince May 1, 2022 Accepting new patients
Connecticut Children's Medical Center Past Accepting new patients

Locations

105 Newtown Rd
#A
Danbury, CT 06810
Phone (860) 545-9395

105 Newtown Rd
Ste A
Danbury, CT 06810

505 Farmington Ave
Fl 1
Farmington, CT 06032

282 Washington St
Ste 5A
Hartford, CT 06106
Phone (860) 545-9630

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

2 Ivy Brook Rd
Ste 213
Shelton, CT 06484
Phone (203) 538-5400

191 Post Rd W
#1
Westport, CT 06880

Interoperability endpoints

  • Direct secure messaging: evisticasampino16540@connecticutchildrens.direct-ci.com

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": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1386039808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "address_2": "CONNECTICUT CHILDREN'S MEDICAL CENTER",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322",
            "telephone_number": "860-545-9973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "address_2": "CONNECTICUT CHILDREN'S MEDICAL CENTER",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322",
            "telephone_number": "860-545-9973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISTICA SAMPINO",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "61689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evisticasampino16540@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "address_2": "Connecticut Children's Medical Center",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.