NPIMap

Individual provider Active NPI

Urielle Marseille, MD

  • Family Medicine Physician
  • Waterford, CT
National Provider Identifier
1477059509
Registry record updated Aug 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
68065 Issued in CT
Practice address
196 Parkway S
Suite 103
Waterford, CT 06385
Phone
(860) 437-6764
Fax
(860) 865-2392
NPI assigned
Apr 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 68065 CT Primary

Addresses

Primary practice location

196 Parkway S
Suite 103
Waterford, CT 06385

Mailing address

99 Hawley LN FL 3
Stratford, CT 06614-1202
Phone (203) 502-4650

Other identifiers 2

IdentifierTypeStateIssuer
68065OtherCTLICENSE
1477059509MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210713003897 CT Practitioner - Internal Medicine 2365787470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York Medical College, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians
Ptsma IncGroup PAC ID 7911800180, shared by 11 NPIs, 173 clinicians

Practice addresses (Care Compare)

196 Pkwy S
Suite 103
Waterford, CT 06385
Phone (860) 443-4383

37 S Broad St
Unit 12
Pawcatuck, CT 06379-7909
Phone (860) 495-1919

Hospital & facility affiliations

  • Yale New Haven Health - Health at Home Southeast Home health agency, Waterford, CT, CCN 077015
  • Home Care Plus, Inc Hospice, Guilford, CT, CCN 071544
  • Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Westerly Hospital Hospital, Westerly, RI, CCN 410013

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Aug 1, 2021 Accepting new patients

Locations

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

99 Hawley Ln
Fl 3
Stratford, CT 06614
Phone (203) 502-4650

196 Parkway S
Ste 103
Waterford, CT 06385
Phone (860) 443-4383

196 Parkway S
Unit 103
Waterford, CT 06385

Interoperability endpoints

  • Direct secure messaging: umarseille526217@direct.ynhh.org

Organizations & group practices 1

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628380800000",
    "number": "1477059509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 HAWLEY LN FL 3",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141202",
            "telephone_number": "203-502-4650",
            "fax_number": "475-246-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S",
            "address_2": "SUITE 103",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "06385",
            "telephone_number": "860-437-6764",
            "fax_number": "860-865-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSEILLE",
        "first_name": "URIELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2021-08-08",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "68065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "68065",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477059509",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, CT

Sources for this page

Verify at the official NPI Registry.