Individual provider Active NPI

Victor Tirado, MD

  • Psychiatry Physician
  • Wethersfield, CT
National Provider Identifier
1609855592
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
042939 Issued in CT
Practice address
929 Silas Deane Hwy
2ND Floor West
Wethersfield, CT 06109-4220
Phone
(860) 372-4731
Fax
(860) 372-4730
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 042939 CT Primary

Addresses

Primary practice location

929 Silas Deane Hwy
2ND Floor West
Wethersfield, CT 06109-4220

Mailing address

929 Silas Deane Hwy
2ND Floor West
Wethersfield, CT 06109-4220
Phone (860) 372-4731

Other identifiers 3

IdentifierTypeStateIssuer
004236015MedicaidCT
24352OtherCTCONTROLLED SUBSTANCE
042939OtherCTPHYSICIAN SURGEON

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050204000538 CT Practitioner - Psychiatry 4082665294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Puerto Rico School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Health Center IncGroup PAC ID 0547169138, 149 clinicians

Practice addresses (Care Compare)

1 Shaws CV
New London, CT 06320-4902
Phone (860) 447-8304

85 Lafayette St
New Britain, CT 06051-1803
Phone (860) 224-3642

929 Silas Deane Hwy
Wethersfield, CT 06109-4220
Phone (860) 372-4731

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042939CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince May 18, 2009 Accepting new patients
Community Health Center Inc Psychiatry CurrentSince May 18, 2009 Accepting new patients
Hartford Community Mental Health Center Inc. PastSince Jul 10, 2011 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: victor.tiradomontanez@chcict.eclinicaldirectplus.com

Organizations & group practices 4

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1609855592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 SILAS DEANE HWY",
            "address_2": "2ND FLOOR WEST",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094220",
            "telephone_number": "860-372-4731",
            "fax_number": "860-372-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 SILAS DEANE HWY",
            "address_2": "2ND FLOOR WEST",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094220",
            "telephone_number": "860-372-4731",
            "fax_number": "860-372-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRADO",
        "first_name": "VICTOR",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "042939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236015",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE",
            "identifier": "24352",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN SURGEON",
            "identifier": "042939",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

Verify at the official NPI Registry.