NPIMap

Individual provider Active NPI

Amy Fraser, PA

  • Physician Assistant
  • Manchester, CT
National Provider Identifier
1659568715
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001998 Issued in CT
Practice address
71 Haynes St
Manchester, CT 06040-4131
Phone
(860) 646-1222
NPI assigned
Oct 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001998 CT
Physician Assistant 363A00000X 001998 CT Primary

Addresses

Primary practice location

71 Haynes St
Manchester, CT 06040-4131

Mailing address

71 Haynes St
Manchester, CT 06040-4131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080109000804 CT Practitioner - Physician Assistant 3476563487 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

18 Haynes St
Uppr Level
Manchester, CT 06040-4111
Phone (860) 649-7557

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 647-6800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001998CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Mar 16, 2020 Accepting new patients
Hartford Hospital CurrentSince Mar 16, 2020 Accepting new patients
Prospect Manchester Hospital, Inc. CurrentSince Nov 8, 2023 Accepting new patients
Eastern Connecticut Medical Professionals Foundation Inc Medical Past Accepting new patients
Trinity Health of New England Provider Network Organization Inc Past Accepting new patients
Eastern Connecticut Medical Professionals Foundation, Inc Past Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

2600 Tamarack Ave
South Windsor, CT 06074
Phone (860) 872-0501

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

Interoperability endpoints

  • Direct secure messaging: amy.fraser@xdr.hhchealthdirect.org

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1659568715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "860-646-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "AMY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001998",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.