Rio Comaduran

Individual provider Active NPI Clinical Social Worker · Woodbury, CT

NPI 1477065043 · NPPES record last updated Nov 29, 2020

Key facts

NPI
1477065043
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
10835 (CT)
Practice address
58 Pomperaug Rd
Woodbury, CT 06798-3713
Phone
(203) 313-5537
NPI assigned
Nov 3, 2017
Sex
Female
Sole proprietor
Yes

Organizations & group practices 9

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Connecticut PC (132 clinicians)

Practice addresses (Care Compare)

191 Albany Tpke
Suite 3
Canton, CT 06019-2571
Phone (203) 819-0789

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210601002432 CT Practitioner - Clinical Social Worker 2769881309 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
10835CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. Current
since Jan 1, 2024
Accepting new patients
A Brand New Day ABA Services LLC Current
since Apr 26, 2020
Accepting new patients
Optum Behavioral Care of Connecticut, P.C. Clinical Current
since Jan 1, 2024
Accepting new patients
The Connection Inc Past Accepting new patients

Locations

191 Albany Tpke
Ste 3
Canton, CT 06019

169 Main St
Fl 3
Middletown, CT 06457
Phone (610) 618-6247

200 W Town St
Norwich, CT 06360
Phone (860) 886-1508

Interoperability endpoints

  • Direct secure messaging: rio.comaduran.1@28623.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10835 CT Yes

Addresses

Primary practice location

58 Pomperaug Rd
Woodbury, CT 06798-3713

Mailing address

94 Dunne Ave
Collinsville, CT 06019-3321
Phone (860) 543-5582

Other practice location 1

17 S Highland St
West Hartford, CT 06119-1826
Phone (413) 588-8153

Other providers in Woodbury, CT

All providers in Woodbury, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.