NPIMap

Individual provider Active NPI

Charles Ekanem, MD

  • Hospitalist Physician
  • East Hartford, CT
National Provider Identifier
1598060907
Registry record updated May 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
50779 Issued in CT
Practice address
96 Silver LN Apt B12
East Hartford, CT 06118-1007
Phone
(860) 597-9371
NPI assigned
Jan 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0000000 ZZ
Hospitalist Physician 208M00000X 50779 CT Primary

Addresses

Primary practice location

96 Silver LN Apt B12
East Hartford, CT 06118-1007

Mailing address

9 Hilldale Road
West Hartford, CT 06117
Phone (860) 597-9371

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
I20120604000193 CT Practitioner - HospitalistPractitioner - Internal Medicine 6709054307 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middlesex HospitalGroup PAC ID 5092611731, 231 clinicians
Bristol Hospital Multi Specialty Group, Inc.Group PAC ID 9032014758, 148 clinicians

Practice addresses (Care Compare)

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-5322

41 Brewster Rd
Bristol, CT 06010-5161
Phone (860) 585-3000

80 S Main St
Middletown, CT 06457-3648
Phone (860) 358-6878

Hospital & facility affiliations

  • Bristol Home Care and Hospice Agency, Inc. Hospice, Bristol, CT, CCN 071517
  • Bristol Hospital Hospital, Bristol, CT, CCN 070029
  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000000ZZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital Internal Medicine CurrentSince Aug 9, 2012 Accepting new patients
Connecticut Pathology Group PC Current Accepting new patients
Middlesex Hospital CurrentSince Aug 9, 2012 Accepting new patients
Hospital Medicine Associates LLC Internal Medicine CurrentSince Nov 3, 2018 Accepting new patients
Bristol Hospital Multi Specialty Group, Inc Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients
Starling Physicians PLLC CurrentSince Mar 1, 2019 Accepting new patients
Starling Physicians, PLLC Internal Medicine CurrentSince Mar 1, 2019 Accepting new patients
Eastern Connecticut Medical Professionals Foundation Inc Internal Medicine Past Accepting new patients

Locations

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

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

172 Kinsley St
Nashua, NH 03060
Phone (603) 595-3926

Interoperability endpoints

  • Direct secure messaging: cekanem18550@middlesexhealthprd.direct-ci.com

Organizations & group practices 8

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": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495670400000",
    "number": "1598060907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HILLDALE ROAD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "06117",
            "telephone_number": "860-597-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 SILVER LN APT B12",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181007",
            "telephone_number": "860-597-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKANEM",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-14",
        "last_updated": "2017-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ZZ",
            "license": "0000000",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "50779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

Verify at the official NPI Registry.