Individual provider Active NPI

Steven H Madonick, M.D.

  • Psychiatry Physician
  • Manchester, CT
National Provider Identifier
1417050360
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036436 Issued in CT
Practice address
444 Center St
Manchester, CT 06040-3926
Phone
(860) 646-3888
Fax
(860) 645-4132
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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 036436 CT Primary

Addresses

Primary practice location

444 Center St
Manchester, CT 06040-3926

Mailing address

995 Day Hill Rd
Windsor, CT 06095-1722
Phone (860) 731-5522

Other identifiers 1

IdentifierTypeStateIssuer
001364363MedicaidCT

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
I20040427001479 CT Practitioner - Psychiatry 8325035850 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York Downstate Medical Center, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Health Resources, Inc. 50 clinicians

Practice addresses (Care Compare)

444 Ctr St
Manchester, CT 06040-3926
Phone (860) 646-3888

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Resources, Inc. CurrentSince Oct 28, 2013 Accepting new patients
Hartford Hospital Psychiatry CurrentSince Jun 1, 2003 Accepting new patients
Hartford Hospital CurrentSince Oct 1, 2004 Accepting new patients
Hartford Hospital CurrentSince Jun 1, 2003 Accepting new patients
State of Connecticut Past Accepting new patients

Locations

693 Bloomfield Ave
Bloomfield, CT 06002
Phone (860) 242-8427

71 Westcott Rd
Danielson, CT 06239
Phone (860) 774-7179

339 Main St
Ste 401
Danielson, CT 06239

153 Hazard Ave
Enfield, CT 06082
Phone (860) 253-5020

200 Retreat Ave
Hartford, CT 06106
Phone (860) 545-7000

444 Center St
Manchester, CT 06040
Phone (860) 646-3888

1310 Main St
Willimantic, CT 06226
Phone (860) 456-0038

995 Day Hill Rd
Windsor, CT 06095
Phone (860) 697-3351

2 Waterside Xing
Ste 401
Windsor, CT 06095

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1417050360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 DAY HILL RD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951722",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403926",
            "telephone_number": "860-646-3888",
            "fax_number": "860-645-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADONICK",
        "first_name": "STEVEN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "036436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001364363",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.