Individual provider Active NPI

Sarah Graceffa, M.D.

  • Obstetrics & Gynecology Physician
  • South Windsor, CT
National Provider Identifier
1669653630
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
050117 Issued in CT
Practice address
2600 Tamarack Ave Ste 200
South Windsor, CT 06074-5560
Phone
(860) 646-1157
NPI assigned
Nov 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 050117 CT Primary

Addresses

Primary practice location

2600 Tamarack Ave Ste 200
South Windsor, CT 06074-5560

Mailing address

44 Jefferson Ave
Danbury, CT 06810-7914
Phone (815) 742-1934

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
I20111221000082 CT Practitioner - Obstetrics/Gynecology 4385810456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OBGYN Group of Eastern Connecticut PCGroup PAC ID 2769370352, 12 clinicians

Practice addresses (Care Compare)

2600 Tamarack Ave
Suite 200
South Windsor, CT 06074-5560
Phone (860) 646-1157

Hospital & facility affiliations

  • Manchester Memorial Hospital Hospital, Manchester, CT, CCN 070027

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
050117CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
OBGYN Group of Eastern Connecticut, P.C. Obstetrics & Gynecology CurrentSince Dec 1, 2011 Accepting new patients

Locations

622 Hebron Ave
Ste 104A
Glastonbury, CT 06033
Phone (860) 646-1157

2600 Tamarack Ave
#200
South Windsor, CT 06074
Phone (860) 646-1157

Organizations & group practices 1

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.

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": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1669653630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 JEFFERSON AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107914",
            "telephone_number": "815-742-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 TAMARACK AVE STE 200",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060745560",
            "telephone_number": "860-646-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACEFFA",
        "first_name": "SARAH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "050117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Windsor, CT

Sources for this page

Verify at the official NPI Registry.