Individual provider Active NPI

Heidi W Nolan, PA-C

  • Medical Physician Assistant
  • New Haven, CT
National Provider Identifier
1578564597
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
000279 Issued in CT
Practice address
874 Howard Ave
New Haven, CT 06519-1106
Phone
(203) 688-8200
Fax
(203) 688-8204
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 000279 CT Primary

Addresses

Primary practice location

874 Howard Ave
New Haven, CT 06519-1106

Mailing address

874 Howard Ave
New Haven, CT 06519-1106
Phone (203) 688-8200

Other identifiers 8

IdentifierTypeStateIssuer
970013793OtherCTRAIL ROAD MEDICARE
061561581OtherCTUNITED HEALTHCARE
008037010MedicaidCT
279001OtherCTCONNECTICARE
P2364340OtherCTOXFORD
290000279CT03OtherCTANTHEM BC/BS
0Q2938OtherCTHEALTH NET
368792OtherCTWELLCARE OF CT

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
I20100622000608 CT Practitioner - Physician Assistant 1759412638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
279CTMDChiropractor
000279CTMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Mill Hill Medical Consultants Inc CurrentSince Apr 8, 2010 Accepting new patients
Northeast Medical Group, Inc. CurrentSince Apr 8, 2010 Accepting new patients
Connecticut Medical Group, LLC Past Accepting new patients

Locations

226 Mill Hill Ave
Bridgeport, CT 06610
Phone (203) 384-3235

2416 Whitney Ave
Hamden, CT 06518
Phone (203) 248-4331

1450 Chapel St
#4E
New Haven, CT 06511

1354 Chapel St
New Haven, CT 06511
Phone (203) 867-8300

874 Howard Ave
New Haven, CT 06519
Phone (203) 688-8200

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

Interoperability endpoints

  • Direct secure messaging: hnolan4117@direct.ynhh.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 2

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1578564597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 HOWARD AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191106",
            "telephone_number": "203-688-8200",
            "fax_number": "203-688-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 HOWARD AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191106",
            "telephone_number": "203-688-8200",
            "fax_number": "203-688-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "HEIDI",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "000279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "970013793",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "061561581",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008037010",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "279001",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2364340",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "290000279CT03",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "0Q2938",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF CT",
            "identifier": "368792",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.