Individual provider Active NPI

Michael George Chase, PA

  • Medical Physician Assistant
  • Norwalk, CT
National Provider Identifier
1447819289
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4449 Issued in CT
Practice address
761 Main Ave Ste 201
Norwalk, CT 06851-1176
Phone
(203) 838-4000
Fax
(203) 845-9535
NPI assigned
Jun 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4449 CT Primary

Addresses

Primary practice location

761 Main Ave Ste 201
Norwalk, CT 06851-1176

Mailing address

761 Main Ave Ste 201
Norwalk, CT 06851-1176
Phone (203) 838-4000

Other identifiers 1

IdentifierTypeStateIssuer
4449OtherCTCT LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190620000432 CT Practitioner - Physician Assistant 3779817085 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Mar 1, 2020 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Mar 1, 2020 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Aug 1, 2021 Accepting new patients

Locations

50 Old Kings Hwy N
Darien, CT 06820
Phone (203) 662-9333

761 Main Ave
Ste 201
Norwalk, CT 06851
Phone (203) 838-4000

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

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

1290 Silas Deane Hwy
Ste 102
Wethersfield, CT 06109

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": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1447819289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE STE 201",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511176",
            "telephone_number": "203-838-4000",
            "fax_number": "203-845-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE STE 201",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511176",
            "telephone_number": "203-838-4000",
            "fax_number": "203-845-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASE",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "4449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LICENSE",
            "identifier": "4449",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.