Individual provider Active NPI

Javeeria Manzoor, M.D

  • Psychiatry Physician
  • Hartford, CT
National Provider Identifier
1396038691
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
53854 Issued in CT
Practice address
675 Tower Ave
Suite 301
Hartford, CT 06112-1273
Phone
(860) 714-2338
NPI assigned
May 18, 2011
Last updated
Nov 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 53854 CT Primary

Addresses

Primary practice location

675 Tower Ave
Suite 301
Hartford, CT 06112-1273

Mailing address

675 Tower Ave
Suite 301
Hartford, CT 06112-1273
Phone (860) 714-2338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191219000833 CA Practitioner - Psychiatry 1456669944 Practice locations: Elk Grove, CA
I20220503002517 CT Practitioner - Psychiatry 1456669944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Mental Health Specialists IncGroup PAC ID 0345130563, 65 clinicians
Value Based Long Term Care K PCGroup PAC ID 1355881418, 61 clinicians

Practice addresses (Care Compare)

270 Farmington Ave
Suite 309
Farmington, CT 06032-1953
Phone (860) 677-5570

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53854CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Psychiatry Center Inc Psychiatry Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1396038691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 TOWER AVE",
            "address_2": "SUITE 301",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121273",
            "telephone_number": "860-714-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 TOWER AVE",
            "address_2": "SUITE 301",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121273",
            "telephone_number": "860-714-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZOOR",
        "first_name": "JAVEERIA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-18",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "53854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.