Individual provider Active NPI

Andrew Ervin Wakefield, M.D.

  • Neurological Surgery Physician
  • Windsor, CT
National Provider Identifier
1407867708
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
037617 Issued in CT
Practice address
360 Bloomfield Ave
Suite 209
Windsor, CT 06095-2700
Phone
(860) 688-1311
Fax
(860) 687-1319
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 037617 CT Primary

Addresses

Primary practice location

360 Bloomfield Ave
Suite 209
Windsor, CT 06095-2700

Mailing address

360 Bloomfield Ave
Suite 209
Windsor, CT 06095-2700
Phone (860) 688-1311

Other identifiers 1

IdentifierTypeStateIssuer
001376179MedicaidCT

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
I20040901000513 CT Practitioner - Neurosurgery 6204801319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Connecticut School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

1559 Sullivan Ave
South Windsor, CT 06074-2766
Phone (860) 724-4443

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion81
Laminectomy or laminotomy (partial removal of spine bones)61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
037617CTMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC Neurological Surgery CurrentSince Jun 1, 2019 Accepting new patients
Neurosurgeons of Central Connecticut, PC Neurological Surgery Past Accepting new patients

Locations

100 Retreat Ave
Ste 705
Hartford, CT 06106
Phone (860) 278-0070

85 Seymour St
Ste 707
Hartford, CT 06106
Phone (860) 246-1636

1559 Sullivan Ave
South Windsor, CT 06074
Phone (860) 696-2350

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

360 Bloomfield Ave
Ste 209
Windsor, CT 06095
Phone (860) 688-1311

Interoperability endpoints

  • Direct secure messaging: andrew.wakefield@xdr.hhchealthdirect.org

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 and National Provider Directory roles.

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236729600000",
    "number": "1407867708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 BLOOMFIELD AVE",
            "address_2": "SUITE 209",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952700",
            "telephone_number": "860-688-1311",
            "fax_number": "860-687-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 BLOOMFIELD AVE",
            "address_2": "SUITE 209",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952700",
            "telephone_number": "860-688-1311",
            "fax_number": "860-687-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEFIELD",
        "first_name": "ANDREW",
        "middle_name": "ERVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2009-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CT",
            "license": "037617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001376179",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CT

Sources for this page

Verify at the official NPI Registry.