Individual provider Active NPI

Aubrie T Nagy, PA-C

  • Physician Assistant
  • New London, CT
National Provider Identifier
1619384609
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3109 Issued in CT
Practice address
435 Montauk Ave
New London, CT 06320-4621
Phone
(860) 444-7400
Fax
(860) 444-7401
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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 3109 CT Primary

Addresses

Primary practice location

435 Montauk Ave
New London, CT 06320-4621

Mailing address

196 Parkway S
Suite 304
Waterford, CT 06385-1234
Phone (860) 442-7027

Other names 1

  • Aubrie T Roche Former name

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
I20141223001619 CT Practitioner - Physician Assistant 6406179472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

120 Dowling Way
Uconn Health Ancillary SVCS
Farmington, CT 06030-3800
Phone (860) 679-2784

135 Dowling Way
Farmington, CT 06030-3800
Phone (860) 679-2784

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11723CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Apr 15, 2020 Accepting new patients
Helar Campos MD & Associates Family Medical Center, LLC CurrentSince Jul 19, 2014 Accepting new patients
State of Connecticut CurrentSince Apr 15, 2020 Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

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

196 Parkway S
Ste 304
Waterford, CT 06385

Interoperability endpoints

  • Direct secure messaging: anagy37203@direct.med.uchc.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1619384609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S",
            "address_2": "SUITE 304",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851234",
            "telephone_number": "860-442-7027",
            "fax_number": "860-444-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204621",
            "telephone_number": "860-444-7400",
            "fax_number": "860-444-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGY",
        "first_name": "AUBRIE",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUBRIE",
            "last_name": "ROCHE",
            "middle_name": "T",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.