Individual provider Active NPI

Mehdi Momen, M.D.

  • Hospitalist Physician
  • Farmington, CT
National Provider Identifier
1396130969
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
063004 Issued in CT
Practice address
263 Farmington Avenue
Farmington, CT 06030-8082
Phone
(860) 679-4477
Fax
(860) 679-1025
NPI assigned
Apr 1, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 63004 CT
Hospitalist Physician 208M00000X 063004 CT Primary

Addresses

Primary practice location

263 Farmington Avenue
Farmington, CT 06030-8082

Mailing address

263 Farmington Avenue
Farmington, CT 06030-8082
Phone (860) 679-4477

Other practice location 1

7901 Broadway # A1-16
Elmhurst, NY 11373-1329
Phone (171) 833-4400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmomen61497@direct.med.uchc.edu

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
I20190619001735 CT Practitioner - Internal Medicine 5496007882 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3692

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
063004CTMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Oct 29, 2022 Accepting new patients
Sound Physicians of Massachusetts II PC Internal Medicine CurrentSince Apr 1, 2022 Accepting new patients
University of Connecticut Health Center Internal Medicine CurrentSince Oct 29, 2022 Accepting new patients
Hospitalist Medicine Physicians of Connecticut, LLC Internal Medicine CurrentSince Jun 1, 2019 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

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

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1396130969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060308082",
            "telephone_number": "860-679-4477",
            "fax_number": "860-679-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060308082",
            "telephone_number": "860-679-4477",
            "fax_number": "860-679-1025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 Broadway # A1-16",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113731329",
            "country_code": "US",
            "telephone_number": "171-833-4400",
            "fax_number": "718-334-5845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOMEN",
        "first_name": "MEHDI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-01",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "63004",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "063004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmomen61497@direct.med.uchc.edu",
            "affiliation": "N",
            "endpointDescription": "UConn",
            "address_1": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060308082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.