Individual provider Active NPI

Maritza Deby Holder, MD

  • Occupational Medicine Physician
  • Wethersfield, CT
National Provider Identifier
1649449364
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
038369 Issued in CT
Practice address
1260 Silas Deane Hwy
Wethersfield, CT 06109-4362
Phone
(860) 571-7253
Fax
(860) 258-3600
NPI assigned
Feb 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 038369 CT Primary

Addresses

Primary practice location

1260 Silas Deane Hwy
Wethersfield, CT 06109-4362

Mailing address

1025 Silas Deane Hwy
Wethersfield, CT 06109-4229
Phone (860) 696-2400

Other identifiers 1

IdentifierTypeStateIssuer
NPIOtherCT1649449364

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
I20100511000760 CT Practitioner - Preventive Medicine 2365570462 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
038369CTMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc CurrentSince Jan 1, 2013 Accepting new patients
Hartford Healthcare Urgent Care Centers, LLC CurrentSince Jan 17, 2018 Accepting new patients
Hartford Healthcare Medical Group, Inc Past Accepting new patients
Hartford Physician Services PC Occupational Medicine Past Accepting new patients

Locations

385 W Main St
Avon, CT 06001
Phone (860) 777-1280

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

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

1025 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 696-2296

1260 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 258-3477

Interoperability endpoints

  • Direct secure messaging: maritza.holder@xdr.hhchealthdirect.org

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": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1649449364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094229",
            "telephone_number": "860-696-2400",
            "fax_number": "860-696-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094362",
            "telephone_number": "860-571-7253",
            "fax_number": "860-258-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "MARITZA",
        "middle_name": "DEBY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-27",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CT",
            "license": "038369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1649449364",
            "identifier": "NPI",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

Verify at the official NPI Registry.