Individual provider Active NPI

Michael J Nolan, PA

  • Surgical Physician Assistant
  • Waterbury, CT
National Provider Identifier
1386664787
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
001644 Issued in CT
Practice address
56 Franklin St
Waterbury, CT 06706-1253
Phone
(203) 709-6360
Fax
(203) 709-5118
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1644 CT
Surgical Physician Assistant 363AS0400X 001644 CT Primary

Addresses

Primary practice location

56 Franklin St
Waterbury, CT 06706-1253

Mailing address

56 Franklin St
Waterbury, CT 06706-1253
Phone (203) 709-6360

Other practice location 1

263 Farmington Ave
Farmington, CT 06030-8063
Phone (860) 679-8080

Other practice location 2

595 Straits Tpke
Watertown, CT 06795-3393
Phone (844) 482-7285

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mnolan48121@direct.med.uchc.edu 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050720000885 CT Practitioner - Physician Assistant 9234166356 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians
Heartcare Associates of Connecticut, LLCGroup PAC ID 1153215199, 7 clinicians
Impact Health PCGroup PAC ID 0941562664, 79 clinicians

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

18 Haynes St
Uppr Level
Manchester, CT 06040-4111
Phone (860) 649-7557

2200 Whitney Ave
Suite 180
Hamden, CT 06518-3691
Phone (203) 407-2500

240 Indian River Rd
Suite C
Orange, CT 06477-3649
Phone (203) 497-3861

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001644CTMDOccupational Therapy Assistant
1644CTMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 29, 2025 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 29, 2025 Accepting new patients
Impact Health P.C. CurrentSince Feb 1, 2026 Accepting new patients
Northeast Medical Group, Inc. CurrentSince Mar 13, 2023 Accepting new patients
Naugatuck Valley Cardiovascular Associates CurrentSince May 28, 2007 Accepting new patients
University of Connecticut Health Center CurrentSince Aug 13, 2021 Accepting new patients
University of Connecticut Health Center CurrentSince Aug 13, 2021 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince Mar 13, 2023 Accepting new patients
Saint Raphael Healthcare System Affiliated Physicians Inc Physician Assistant Past Accepting new patients
Saint Raphael Faculty Physicians Physician Assistant Past Accepting new patients

Locations

130 Division St
Derby, CT 06418
Phone (203) 732-1330

47 Palomba Dr
Ste 202
Enfield, CT 06082
Phone (860) 247-3279

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

75 Holly Hill Ln
Greenwich, CT 06830
Phone (203) 661-3333

2200 Whitney Ave
Ste 180
Hamden, CT 06518
Phone (203) 407-5800

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

1625 Straits Tpke
Ste 209
Middlebury, CT 06762
Phone (203) 758-9100

300 Seaside Ave
Milford, CT 06460
Phone (203) 876-4000

1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151

1354 Chapel St
New Haven, CT 06511
Phone (203) 867-8300

79 Wawecus St
Ste 104
Norwich, CT 06360
Phone (860) 237-5458

240 Indian River Rd
Ste C
Orange, CT 06477
Phone (203) 497-3867

240 Indian River Rd
Ste C7
Orange, CT 06477
Phone (203) 497-3867

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: michaelj.nolan@xdr.hhchealthdirect.org
  • Direct secure messaging: michaelnolan@amggw.allscriptsdirect.net

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 3

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386664787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061253",
            "telephone_number": "203-709-6360",
            "fax_number": "203-709-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061253",
            "telephone_number": "203-709-6360",
            "fax_number": "203-709-5118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060308063",
            "country_code": "US",
            "telephone_number": "860-679-8080",
            "fax_number": "860-679-1430",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "595 Straits Tpke",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "CT",
            "postal_code": "067953393",
            "country_code": "US",
            "telephone_number": "844-482-7285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "1644",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "001644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnolan48121@direct.med.uchc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "263 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060308063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.