Individual provider Active NPI

Mia F Williams, PA

  • Physician Assistant
  • Groton, CT
National Provider Identifier
1598731572
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1145 Poquonnock Rd
Groton, CT 06340-4620
Phone
(855) 700-8184
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1145 Poquonnock Rd
Groton, CT 06340-4620

Mailing address

415 W Golf Rd Ste 26
Arlington Heights, IL 60005-3923
Phone (855) 700-8184

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
I20040128000425 CT Practitioner - Physician Assistant 2961305032 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Helar Campos MD & Associates Family Medical Center, LLC CurrentSince Jun 1, 2007 Accepting new patients
Comprehensive Rehab Consultants PLLC CurrentSince Feb 1, 2025 Accepting new patients
Hartford Physician Services PC Physician Assistant Past Accepting new patients

Locations

1145 Poquonnock Rd
Groton, CT 06340
Phone (860) 446-3134

435 Montauk Ave
New London, CT 06320
Phone (860) 443-1136

196 Parkway S
Ste 304
Waterford, CT 06385

1 Emily Way
West Hartfrd, CT 06107
Phone (860) 561-7022

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1598731572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W GOLF RD STE 26",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600053923",
            "telephone_number": "855-700-8184",
            "fax_number": "224-633-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 POQUONNOCK RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404620",
            "telephone_number": "855-700-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MIA",
        "middle_name": "F",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

Verify at the official NPI Registry.