Individual provider Active NPI

Monica Srodon, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Manchester, CT
National Provider Identifier
1568457893
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
046164 Issued in CT
Practice address
71 Haynes St
Manchester, CT 06040-4131
Phone
(860) 647-6487
Fax
(860) 647-6447
NPI assigned
Sep 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 046164 CT
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 046164 CT Primary

Addresses

Primary practice location

71 Haynes St
Manchester, CT 06040-4131

Mailing address

PO Box 206
New Haven, CT 06501-0206
Phone (203) 397-8000

Other practice location 1

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 647-6487

Other identifiers 4

IdentifierTypeStateIssuer
A524580OtherCTOXFORD
11-04296OtherCTUNITED HEALTHCARE
500HBL161CT01OtherCTBLUE CROSS
008001162MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080401000292 CT Practitioner - Pathology 3274576210 Reassigns benefits to 2 organizations
I20210217000954 MA Practitioner - Pathology 3274576210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Maryland School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Connecticut Pathology Consultants, PCGroup PAC ID 3173511581, 19 clinicians

Practice addresses (Care Compare)

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 647-6487

94 S St
Southbridge, MA 01550-4000
Phone (508) 765-9771

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
55.67 of 100Reported as group
Quality
46.42
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046164CTMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Gi PLLC Anatomic Pathology & Clinical Pathology CurrentSince Dec 1, 2016 Accepting new patients
Eastern Connecticut Pathology Consultants, PC Anatomic Pathology & Clinical Pathology CurrentSince May 12, 2008 Accepting new patients
Eastern Connecticut Pathology Consultants, P.C. Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

85 Seymour St
Ste 1000
Hartford, CT 06106
Phone (860) 246-2571

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

30 Waterchase Dr
Rocky Hill, CT 06067
Phone (860) 257-4131

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

575 Beech St
Holyoke, MA 01040
Phone (413) 534-2570

94 South St
Southbridge, MA 01550
Phone (508) 764-2772

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 4

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1568457893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 206",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065010206",
            "telephone_number": "203-397-8000",
            "fax_number": "203-389-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "860-647-6487",
            "fax_number": "860-647-6447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 Haynes St",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060404131",
            "country_code": "US",
            "telephone_number": "860-647-6487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRODON",
        "first_name": "MONICA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "046164",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CT",
            "license": "046164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "A524580",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "11-04296",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "500HBL161CT01",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008001162",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.