Active NPI
Mayeda Gynecology, PLLC
- Obstetrics & Gynecology Physician
- Waterford, CT
National Provider Identifier
1629740071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Legal business name
- MAYEDA GYNECOLOGY, PLLC
- Practice address
- 914 Hartford Tpke Ste 206
Waterford, CT 06385-4276 - Phone
- (860) 442-1177
- Fax
- (860) 442-1181
- NPI assigned
- Oct 4, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Logan Jean Rowley
- Title
- Practice Manager
- Phone
- (860) 442-1177
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | Primary |
Addresses
Primary practice location
914 Hartford Tpke Ste 206
Waterford, CT 06385-4276
Mailing address
914 Hartford Tpke Ste 206
Waterford, CT 06385-4276
Phone (860) 442-1177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 07D2258969 | Mayeda Gynecology PLLC | Certificate of waiver | Apr 28, 2028 |
National Provider Directory
National Provider DirectoryLocations
4 Shaws Cv
Ste 105
New London, CT 06320
Phone (860) 447-8664
914 Hartford Tpke
Ste 206
Waterford, CT 06385
Phone (860) 421-4695
Interoperability endpoints
- https://api.platform.athenahealth.com/24127/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Waterford, CT
- NPI 1083631055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633305600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1783382400000",
"number": "1629740071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "914 HARTFORD TPKE STE 206",
"city": "WATERFORD",
"state": "CT",
"postal_code": "063854276",
"telephone_number": "860-442-1177",
"fax_number": "860-442-1181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "914 HARTFORD TPKE STE 206",
"city": "WATERFORD",
"state": "CT",
"postal_code": "063854276",
"telephone_number": "860-442-1177",
"fax_number": "860-442-1181"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAYEDA GYNECOLOGY, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-10-04",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A",
"authorized_official_last_name": "ROWLEY",
"authorized_official_first_name": "LOGAN",
"authorized_official_middle_name": "JEAN",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "860-442-1177"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waterford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.