Individual provider Active NPI

Maria Diana Avellino, C.N.M.

  • Advanced Practice Midwife
  • Manchester, CT
National Provider Identifier
1437389715
Registry record updated Sep 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
000318 Issued in CT
Practice address
388 West Center St
Manchester, CT 06040
Phone
(860) 649-1120
Fax
(860) 645-8541
NPI assigned
Jul 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN2260816 MA
Advanced Practice Midwife 367A00000X 000318 CT Primary

Addresses

Primary practice location

388 West Center St
Manchester, CT 06040

Mailing address

388 West Center St
Manchester OB-GYN Assoc
Manchester, CT 06040
Phone (860) 649-1120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221123000426 NY Practitioner - Certified Nurse Midwife (CNM) 9234275561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Yale University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

107 W 4TH St
Mount Vernon, NY 10550-4002
Phone 9146997200660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
000318CTMDAddiction (Substance Use Disorder) Counselor
RN2260816MAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Vernon Neighborhood Health Center Inc CurrentSince Sep 25, 2022 Accepting new patients
Mount Vernon Neighborhood Health Center, Inc. CurrentSince Sep 25, 2022 Accepting new patients
Mount Vernon Neighborhood Health Center, Inc. Past Accepting new patients

Locations

107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

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.

NPI Registry JSON

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253577600000",
    "number": "1437389715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 WEST CENTER ST",
            "address_2": "MANCHESTER OB-GYN ASSOC",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "06040",
            "telephone_number": "860-649-1120",
            "fax_number": "860-645-8541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 WEST CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "06040",
            "telephone_number": "860-649-1120",
            "fax_number": "860-645-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVELLINO",
        "first_name": "MARIA",
        "middle_name": "DIANA",
        "credential": "C.N.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-21",
        "last_updated": "2009-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN2260816",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CT",
            "license": "000318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.