NPIMap

Organization Active NPI

MC Diagnostic of Connecticut, P.C.

  • Family Nurse Practitioner
  • Rocky Hill, CT
National Provider Identifier
1386821932
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MC DIAGNOSTIC OF CONNECTICUT, P.C.
Practice address
323 Cromwell Ave
Rocky Hill, CT 06067-1801
Phone
(866) 389-2727
Fax
(401) 406-3539
NPI assigned
Jan 25, 2008
Last updated
Jul 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Deborah Pincince
Title
Administrator
Phone
(401) 770-3813

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Family Nurse Practitioner 363LF0000X Primary
Professional Counselor 101YP2500X
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

323 Cromwell Ave
Rocky Hill, CT 06067-1801

Mailing address

PO Box 772
Minuteclinic Credentialing
Woonsocket, RI 02895-0784
Phone (866) 389-2727

Other identifiers 1

IdentifierTypeStateIssuer
DO1751OtherCTMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080126000057 CT Part B Supplier - Clinic/Group Practice 0941382113 Receives reassigned benefits from 124 practitioners
Practice locations: Southbury, CT; Waterbury, CT; Stratford, CT; South Windsor, CT; Rocky Hill, CT; Riverside, CT; Old Saybrook, CT; Norwich, CT…

National Provider Directory

National Provider Directory

Locations

20 Bank St
Granby, CT 06035
Phone (860) 653-4221

1057 Boston Post Rd
Guilford, CT 06437
Phone (203) 458-1444

734 Bridgeport Ave
Milford, CT 06460
Phone (203) 877-8127

40 East St
New Milford, CT 06776
Phone (860) 354-4455

6 Willard Rd
Norwalk, CT 06851
Phone (203) 750-6901

279 Boston Post Rd
Orange, CT 06477
Phone (203) 795-4704

1239 E Putnam Ave
Riverside, CT 06878
Phone (203) 675-9805

22 Depot Hill Rd
Southbury, CT 06488
Phone (203) 262-1831

1 Hawley Ln
Stratford, CT 06614
Phone (203) 383-7735

Practitioners & affiliated clinicians

Practitioners 141

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 141

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1386821932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772",
            "address_2": "MINUTECLINIC CREDENTIALING",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028950784",
            "telephone_number": "866-389-2727",
            "fax_number": "401-406-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 CROMWELL AVE",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060671801",
            "telephone_number": "866-389-2727",
            "fax_number": "401-406-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MC DIAGNOSTIC OF CONNECTICUT, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "PINCINCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-770-3813"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DO1751",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Hill, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.