Organization Active NPI

Heritage Internal Medicine Associates LLC

  • Internal Medicine Physician
  • Manchester, CT
National Provider Identifier
1609051044
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
038384 Issued in CT
Legal business name
HERITAGE INTERNAL MEDICINE ASSOCIATES LLC
Practice address
945 Main St
Suite 102
Manchester, CT 06040-6064
Phone
(860) 643-0319
Fax
(860) 812-0310
NPI assigned
Jan 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Authorized official

Name
Dr. Marjorie Arzt Garrett, M.D.NPI 1710955935
Title
Owner
Phone
(860) 801-0316

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 038384 CT Primary

Addresses

Primary practice location

945 Main St
Suite 102
Manchester, CT 06040-6064

Mailing address

945 Main St
Suite 102
Manchester, CT 06040-6064
Phone (860) 643-0319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080326000550 CT Part B Supplier - Clinic/Group Practice 2365528791 Receives reassigned benefits from 6 practitioners
Practice locations: Manchester, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D1078372Heritage Internal Medicine Associates945 Main Street, Suite 102, Manchester, CT 06040Certificate of waiverJan 7, 2028

National Provider Directory

National Provider Directory

Locations

1824 Manchester Rd
Glastonbury, CT 06033
Phone (860) 647-1695

949 Main St Ste 106
Manchester, CT 06040

945 Main St
Ste 102
Manchester, CT 06040
Phone (860) 643-0319

946 Main St Ste 103
Manchester, CT 06040

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362096000000",
    "number": "1609051044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 MAIN ST",
            "address_2": "SUITE 102",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406064",
            "telephone_number": "860-643-0319",
            "fax_number": "860-801-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 MAIN ST",
            "address_2": "SUITE 102",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406064",
            "telephone_number": "860-643-0319",
            "fax_number": "860-812-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE INTERNAL MEDICINE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2013-03-01",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_middle_name": "ARZT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-801-0316",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "038384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.