Individual provider Active NPI

Lucinda Marie Gonzales, MS CCC-SLP

  • Speech-Language Pathologist
  • New Britain, CT
National Provider Identifier
1609157916
Registry record updated Aug 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
003913 Issued in CT
Practice address
214 Merigold Dr
New Britain, CT 06053-1447
Phone
(203) 376-8449
NPI assigned
Aug 31, 2011
Last updated
Aug 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 003913 CT Primary

Addresses

Primary practice location

214 Merigold Dr
New Britain, CT 06053-1447

Mailing address

Uconn Medical Group
850 Bolton Road, U-85
Storrs, CT 06269
Phone (860) 486-2629

Other names 1

  • Lucinda Brodeur Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180411001137 CT Practitioner - Qualified Speech Language Pathologist 7517220221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The University of ConnecticutGroup PAC ID 2062507817, 7 clinicians

Practice addresses (Care Compare)

2 Alethia Dr
U 1085
Storrs, CT 06269-1085
Phone (860) 486-2629

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Speech-Language Pathologist CurrentSince May 1, 2022 Accepting new patients
University of Connecticut Health Center Past Accepting new patients
State of Connecticut Health Center Past Accepting new patients

Locations

2 Alethia Dr
#U1085
Storrs Mansfield, CT 06269
Phone (860) 486-2629

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503532800000",
    "number": "1609157916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UCONN MEDICAL GROUP",
            "address_2": "850 BOLTON ROAD, U-85",
            "city": "STORRS",
            "state": "CT",
            "postal_code": "06269",
            "telephone_number": "860-486-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 MERIGOLD DR",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060531447",
            "telephone_number": "203-376-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "LUCINDA",
        "middle_name": "MARIE",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2017-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "003913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCINDA",
            "last_name": "BRODEUR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Britain, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2017; 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.