Individual provider Active NPI

Mackenzie Corbeil O'Neill, APRN

  • Acute Care Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1629454889
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
6226 Issued in CT
Practice address
80 Seymour St
Hartford Hospital Surgery Department
Hartford, CT 06102-5037
Phone
(860) 972-4670
NPI assigned
Aug 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 006226 CT
Acute Care Nurse Practitioner 363LA2100X 6226 CT Primary

Addresses

Primary practice location

80 Seymour St
Hartford Hospital Surgery Department
Hartford, CT 06102-5037

Mailing address

80 Seymour St
Hartford Hospital Surgery Department
Hartford, CT 06102-5037
Phone (860) 972-4670

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
I20151119000474 CT Practitioner - Nurse Practitioner 3971803156 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6226CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Oct 12, 2015 Accepting new patients
Hartford Hospital CurrentSince Oct 12, 2015 Accepting new patients
Hartford Healthcare Medical Group, Inc Nurse Practitioner CurrentSince Jan 1, 2017 Accepting new patients
Hartford Hospital CurrentSince Oct 12, 2015 Accepting new patients

Locations

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

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": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1629454889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "address_2": "HARTFORD HOSPITAL SURGERY DEPARTMENT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-972-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "address_2": "HARTFORD HOSPITAL SURGERY DEPARTMENT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-972-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "MACKENZIE",
        "middle_name": "CORBEIL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "006226",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "6226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.