NPIMap

Individual provider Active NPI

Mae Whelan, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • New London, CT
National Provider Identifier
1528388345
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
054187 Issued in CT
Practice address
194 Howard St
New London, CT 06320-5544
Phone
(860) 444-4737
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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 054187 CT
Internal Medicine Physician 207R00000X LP01967 RI
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 054187 CT Primary

Addresses

Primary practice location

194 Howard St
New London, CT 06320-5544

Mailing address

194 Howard St
New London, CT 06320-5544
Phone (860) 444-4737

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
I20151014000533 CT Practitioner - EndocrinologyPractitioner - Internal Medicine 2365660180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Albany Medical College of Union University, 2010
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

Practice addresses (Care Compare)

91 Voluntown Rd
Pawcatuck, CT 06379-1366
Phone (860) 599-5477

Hospital & facility affiliations

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

State licenses

LicenseStateTypeSpecialty
054187CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Apr 1, 2017 Accepting new patients

Locations

194 Howard St
New London, CT 06320
Phone (860) 442-0564

91 Voluntown Rd
Pawcatuck, CT 06379
Phone (860) 599-5477

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

Interoperability endpoints

  • Direct secure messaging: mwhelan329791@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 8

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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1528388345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 HOWARD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205544",
            "telephone_number": "860-444-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 HOWARD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205544",
            "telephone_number": "860-444-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHELAN",
        "first_name": "MAE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "054187",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP01967",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CT",
            "license": "054187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.