Courtney Lynne Souza, MD
Individual provider Active NPI Pediatrics Physician · Weatogue, CT
NPI 1457739583 · NPPES record last updated Jan 11, 2026
Key facts
- NPI
- 1457739583
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 064738 (CT)
- Practice address
- 225 Hopmeadow St
Weatogue, CT 06089 - Phone
- (860) 658-0465
- Fax
- (860) 658-5963
- NPI assigned
- May 8, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220215001323 | CT | Practitioner - Pediatric Medicine | 8123432887 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 064738 | CT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Starling Physicians PLLC | Current |
Accepting new patients | |
| Starling Physicians, PLLC | Current |
Accepting new patients | |
| Prohealth Physicians PC | Pediatrics | Current |
Accepting new patients |
| Blackstone Valley Pediatrics | Pediatrics | Past | Accepting new patients |
| Starling Physicians, PLLC | Past | Accepting new patients | |
| Just Kids R.I. Sick Care LLC | Pediatrics | Past | Accepting new patients |
Locations
100 Simsbury Rd
Avon, CT 06001
Phone (860) 659-8830
375 Willard Ave
Newington, CT 06111
Phone (860) 666-5252
2110 Silas Deane Hwy
Rocky Hill, CT 06067
225 Hopmeadow St
Weatogue, CT 06089
Phone (860) 651-0277
115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DIBCAA
- courtney.souza.npi1457739583.phpct@direct.optumcare.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 064738 | CT | Yes |
Addresses
Primary practice location
225 Hopmeadow St
Weatogue, CT 06089
Mailing address
225 Hopmeadow St
Weatogue, CT 06089-9782
Phone (860) 658-0465
Other providers in Weatogue, CT
- Serene Solutions, LLC
- Breanne Sills
- Simsbury Pediatric & Adolescent Dentistry, LLC
- Jacqueline Ms Sloan
- Julianne Kelley Smith
- Daniel L Spada
- Marissa Lynn Stafford
- Russell Stone
- Heather Anne Talledo
- Nicole Thibault
All providers in Weatogue, CT · Pediatrics Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.