Corey W Wynn, MD, MED

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

74368 Issued in CT

Practice address

85 Seymour St
Hartford, CT 06106-5501

Phone

(860) 545-9440

NPI assigned

Mar 20, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Pediatric Medicine

Education

New York Medical College, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connecticut Children's Specialty Group, IncGroup PAC ID 6002720117, 144 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Education

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwynn85971@connecticutchildrens.direct-ci.com

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.

• Connecticut Children's Specialty Group, Inc.

  • Pediatrics Physician
  • Hartford, CT
  • NPI 1669448882

  Pediatric Pulmonology

  Medicare reassignment Care Compare group NPD
• Connecticut Children's Specialty Group, Inc.

  • Ophthalmology Physician
  • Glastonbury, CT
  • NPI 1568056984

  Pediatric Pulmonology

  NPD
• Connecticut Children's Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Hartford, CT
  • NPI 1578106951
  NPD (past)

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1386185627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST STE 500",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065501",
            "telephone_number": "860-545-9440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Burnet Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452293026",
            "country_code": "US",
            "telephone_number": "513-636-6771",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 E Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112991",
            "country_code": "US",
            "telephone_number": "312-227-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYNN",
        "first_name": "COREY",
        "middle_name": "W",
        "credential": "MD, MED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "CT",
            "license": "74368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Lee Wrubel, M.D.
• Amy Carlucci Wu, M.D.
• Ulysses Wu
• Tirhas Wubet, RN
• Rafael Wurzel, M.D.
• Alison Couture Wyse, CRNA
• Beata Wyszynski
• Conway Xu, MD
• Wei Xu, M.D.
• Xinyang Xu, DO

• Pediatric Pulmonology Physician in Hartford, CT
• Providers in Hartford, CT by specialty
• Pediatric Pulmonology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.

Verify at the official NPI Registry.