Individual provider Active NPI

Ellen Olarsch Nestler, M.D.

  • Internal Medicine Physician
  • Hartford, CT
National Provider Identifier
1427060805
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
030865 Issued in CT
Practice address
131 Coventry St
Burgdorf Clinic 2ND Floor - Administration
Hartford, CT 06112-1548
Phone
(860) 714-3690
Fax
(860) 714-8683
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 030865 CT Primary

Addresses

Primary practice location

131 Coventry St
Burgdorf Clinic 2ND Floor - Administration
Hartford, CT 06112-1548

Mailing address

131 Coventry St
Burgdorf Clinic 2ND Floor - Administration
Hartford, CT 06112-1548
Phone (860) 714-3690

Other identifiers 1

IdentifierTypeStateIssuer
001308651MedicaidCT

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
I20101214001273 CT Practitioner - Internal Medicine 4789871898 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
030865CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Aug 26, 2018 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Aug 26, 2018 Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

675 Tower Ave
Ste 312
Hartford, CT 06112
Phone (860) 243-9421

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

131 Coventry St
#2
Hartford, CT 06112
Phone (860) 714-2813

Organizations & group practices 2

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1427060805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 COVENTRY ST",
            "address_2": "BURGDORF CLINIC 2ND FLOOR - ADMINISTRATION",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121548",
            "telephone_number": "860-714-3690",
            "fax_number": "860-714-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 COVENTRY ST",
            "address_2": "BURGDORF CLINIC 2ND FLOOR - ADMINISTRATION",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121548",
            "telephone_number": "860-714-3690",
            "fax_number": "860-714-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESTLER",
        "first_name": "ELLEN",
        "middle_name": "OLARSCH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "030865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001308651",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.