Individual provider Active NPI

Andrea Dias Murphy, APRN

  • Nurse Practitioner
  • South Windsor, CT
National Provider Identifier
1467709097
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
005071 Issued in CT
Practice address
1741 Ellington Rd
South Windsor, CT 06074-2720
Phone
(860) 263-3603
NPI assigned
Aug 14, 2012
Last updated
Aug 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 005071 CT Primary

Addresses

Primary practice location

1741 Ellington Rd
South Windsor, CT 06074-2720

Mailing address

772 Mountain Rd
West Hartford, CT 06117-1142
Phone (508) 951-7183

Other identifiers 1

IdentifierTypeStateIssuer
004050712MedicaidCT

Other names 1

  • Andrea Marie Dias Former name

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
I20121109000003 CT Practitioner - Nurse Practitioner 0345491817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Connecticut School of Medicine, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Headache Care Center PLLCGroup PAC ID 1557611787, 4 clinicians

Practice addresses (Care Compare)

1741 Ellington Rd
Suite 1
South Windsor, CT 06074-2720
Phone (860) 263-3603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
005071CTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Sep 18, 2012 Accepting new patients
Headache Care Center PLLC CurrentSince Apr 1, 2023 Accepting new patients

Locations

1741 Ellington Rd
Ste 1
South Windsor, CT 06074
Phone (860) 263-3603

65 Memorial Rd
West Hartford, CT 06107
Phone (860) 231-1707

65 Memorial Rd
Ste 430
West Hartford, CT 06107
Phone (860) 231-0751

65 Memorial Rd
Ste 508
West Hartford, CT 06107

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1467709097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "772 MOUNTAIN RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061171142",
            "telephone_number": "508-951-7183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 ELLINGTON RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742720",
            "telephone_number": "860-263-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "ANDREA",
        "middle_name": "DIAS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-14",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "005071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004050712",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "DIAS",
            "middle_name": "MARIE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Windsor, CT

Sources for this page

Verify at the official NPI Registry.