Individual provider Active NPI

Tito Anthony Wiltsie, PA-C

  • Medical Physician Assistant
  • Avon, CT
National Provider Identifier
1669171807
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
6050 Issued in CT
Practice address
385 W Main St
Avon, CT 06001-4357
Phone
(860) 777-1280
NPI assigned
Feb 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CT
Medical Physician Assistant 363AM0700X 6050 CT Primary

Addresses

Primary practice location

385 W Main St
Avon, CT 06001-4357

Mailing address

385 W Main St
Avon, CT 06001-4357
Phone (860) 777-1280

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
I20230403000582 CT Practitioner - Physician Assistant 7315312493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.78 of 100Reported as group
Quality
85.61
Promoting interoperability
100
Improvement activities
40
Cost
46.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6050CTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince Nov 1, 2024 Accepting new patients
Middlesex Hospital CurrentSince Nov 1, 2024 Accepting new patients

Locations

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

Interoperability endpoints

  • Direct secure messaging: twiltsie94465@middlesexhealthprd.direct-ci.com
  • Direct secure messaging: twiltsie493803@xdr.hhchealthdirect.org

Organizations & group practices 3

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1669171807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 W MAIN ST",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014357",
            "telephone_number": "860-777-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 W MAIN ST",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014357",
            "telephone_number": "860-777-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTSIE",
        "first_name": "TITO",
        "middle_name": "ANTHONY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "6050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.