Individual provider Active NPI

Elizabeth Susan Doty

  • Family Nurse Practitioner
  • Wethersfield, CT
National Provider Identifier
1558853515
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7641 Issued in CT
Practice address
1260 Silas Deane Hwy
Wethersfield, CT 06109
Phone
(860) 253-5330
NPI assigned
Jun 5, 2018
Last updated
Aug 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7641 CT Primary

Addresses

Primary practice location

1260 Silas Deane Hwy
Wethersfield, CT 06109

Mailing address

77 Lee Dr
Southington, CT 06489-2926
Phone (860) 944-5849

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180807000768 CT Practitioner - Nurse Practitioner 9830447945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Connecticut School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Starling Physicians, PLLCGroup PAC ID 7517863749, 276 clinicians

Practice addresses (Care Compare)

1260 Silas Deane Hwy
Wethersfield, CT 06109-4362
Phone (860) 832-4666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7641CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Starling Physicians, PLLC CurrentSince Aug 1, 2018 Accepting new patients
Starling Physicians PLLC CurrentSince Aug 1, 2018 Accepting new patients
Starling Physicians, PLLC Past Accepting new patients

Locations

100 Simsbury Rd
Avon, CT 06001
Phone (860) 659-8830

2110 Silas Deane Hwy
Rocky Hill, CT 06067

1260 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 258-3477

Interoperability endpoints

  • Direct secure messaging: elizabeth.doty@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1558853515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 LEE DR",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892926",
            "telephone_number": "860-944-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "06109",
            "telephone_number": "860-253-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTY",
        "first_name": "ELIZABETH",
        "middle_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "7641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

Verify at the official NPI Registry.