NPIMap

Individual provider Active NPI

John Monroe Jr., MD

  • Family Medicine Physician
  • New London, CT
National Provider Identifier
1508863226
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
033009 Issued in CT
Practice address
1 Shaws CV
New London, CT 06320-4902
Phone
(860) 447-8304
Fax
(860) 443-8720
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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 033009 CT Primary

Addresses

Primary practice location

1 Shaws CV
New London, CT 06320-4902

Mailing address

575 Main St 2ND Floor
Attn: Credentialing Department
Middletown, CT 06457-2718
Phone (860) 347-6971

Other identifiers 1

IdentifierTypeStateIssuer
008010088MedicaidCT

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
I20110429000362 CT Practitioner - Family Practice 1355526781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Center IncGroup PAC ID 0547169138, 149 clinicians

Practice addresses (Care Compare)

1 Shaws CV
New London, CT 06320-4902
Phone (860) 447-8304

Hospital & facility affiliations

  • Yale New Haven Health - Health at Home Southeast Home health agency, Waterford, CT, CCN 077015
  • Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
  • William W Backus Hospital Hospital, Norwich, CT, CCN 070024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
033009CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc Family Medicine CurrentSince Sep 14, 1993 Accepting new patients
Community Health Center Inc CurrentSince Sep 14, 1993 Accepting new patients
Community Health Center Inc. Family Medicine Past Accepting new patients

Locations

575 Main St
Ste 2
Middletown, CT 06457

1 Shaws Cv
New London, CT 06320
Phone (860) 447-8304

Interoperability endpoints

  • Direct secure messaging: john.monroe@chcict.eclinicaldirectplus.com

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1508863226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 MAIN ST 2ND FLOOR",
            "address_2": "ATTN: CREDENTIALING DEPARTMENT",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572718",
            "telephone_number": "860-347-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHAWS CV",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204902",
            "telephone_number": "860-447-8304",
            "fax_number": "860-443-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONROE",
        "first_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "033009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008010088",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.