Individual provider Active NPI

Carlos Antonio Hernandez-Avila, MD

  • Addiction Psychiatry Physician
  • Newington, CT
National Provider Identifier
1467511568
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
License
035921 Issued in CT
Practice address
525 Russell Road
Cedarcrest Hospital Human Resources
Newington, CT 06111
Phone
(860) 666-7621
Fax
(860) 594-4900
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 035921 CT
Psychiatry Physician 2084P0800X 035921 CT
Addiction Psychiatry Physician 2084P0802X 035921 CT Primary

Addresses

Primary practice location

525 Russell Road
Cedarcrest Hospital Human Resources
Newington, CT 06111

Mailing address

525 Russell Road
Cedarcrest Hospital Human Resources
Newington, CT 06111
Phone (860) 666-7621

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
I20040223000649 CT Practitioner - PsychiatryPractitioner - Addiction Medicine 0941196521 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035921CTMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harvest Healthcare LLC Psychiatry CurrentSince Aug 23, 2021 Accepting new patients
State of Connecticut CurrentSince Jan 1, 2022 Accepting new patients

Locations

21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182

1635 Central Ave
Bridgeport, CT 06610
Phone (203) 551-7464

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

Organizations & group practices 4

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1467511568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 RUSSELL ROAD",
            "address_2": "CEDARCREST HOSPITAL HUMAN RESOURCES",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "06111",
            "telephone_number": "860-666-7621",
            "fax_number": "860-594-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 RUSSELL ROAD",
            "address_2": "CEDARCREST HOSPITAL HUMAN RESOURCES",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "06111",
            "telephone_number": "860-666-7621",
            "fax_number": "860-594-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ-AVILA",
        "first_name": "CARLOS",
        "middle_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "CT",
            "license": "035921",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "035921",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CT",
            "license": "035921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newington, CT

Sources for this page

Verify at the official NPI Registry.