Individual provider Active NPI

Nsisongikanabasi Mfon Udoh, MD

  • Family Medicine Physician
  • Hartford, CT
National Provider Identifier
1487279824
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
76284 Issued in CT
Practice address
80 Seymour St BLDG 502
Hartford, CT 06102-8000
Phone
(860) 972-0549
Fax
(860) 545-5221
NPI assigned
Jun 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 76284 CT
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 76284 CT Primary

Addresses

Primary practice location

80 Seymour St BLDG 502
Hartford, CT 06102-8000

Mailing address

6425 S Lowe Ave Apt 513
Chicago, IL 60621-2726
Phone (773) 251-3585

Other practice location 1

7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone (773) 947-7500

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
I20231127000655 CT Practitioner - Family PracticePractitioner - General PracticePractitioner - Internal Medicine 1658729082 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Margaret Chustecka Internal Medicine of Greater New HavenGroup PAC ID 3274557152, 30 clinicians
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

1952 Whitney Ave
Hamden, CT 06517-1209
Phone (203) 848-1803

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 972-0549

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Oct 15, 2023 Accepting new patients
Margaret Chustecka Internal Medicine of Greater New Haven Internal Medicine CurrentSince Jun 30, 2025 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Oct 15, 2023 Accepting new patients

Locations

1952 Whitney Ave
Ste 3
New Haven, CT 06517
Phone (203) 288-0129

1952 Whitney Ave
New Haven, CT 06517
Phone (203) 553-7626

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

385 Main St
West Haven, CT 06516
Phone (203) 848-6710

Interoperability endpoints

  • Direct secure messaging: nsisong.udoh@xdr.hhchealthdirect.org

Organizations & group practices 3

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 6

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": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1487279824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 S LOWE AVE APT 513",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606212726",
            "telephone_number": "773-251-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST BLDG 502",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061028000",
            "telephone_number": "860-972-0549",
            "fax_number": "860-545-5221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7531 S Stony Island Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606493954",
            "country_code": "US",
            "telephone_number": "773-947-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UDOH",
        "first_name": "NSISONGIKANABASI",
        "middle_name": "MFON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "76284",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "76284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.