Gemstonn Boniface Alegre, MD
Individual provider Active NPI Family Medicine Physician · Waterford, CT
NPI 1699355776 · NPPES record last updated Sep 11, 2024
Key facts
- NPI
- 1699355776
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 79071 (CT)
- Practice address
- 5 Dayton Rd Ste 102
Waterford, CT 06385-4279 - Phone
- (860) 271-2400
- NPI assigned
- Apr 12, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Hartford Healthcare Medical Group Inc
Practice addresses (Care Compare)
55 Meriden Ave
Suite 1D
Southington, CT 06489-3239
Phone (860) 276-5144
Hospital & facility affiliations
- Hartford Healthcare at Home
- Yale New Haven Health - Health at Home Southeast
- Lawrence & Memorial Hospital
- William W Backus Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240912000005 | CT | Practitioner - Family Practice | 5193265569 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79071 | CT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group, Inc | Family Medicine | Current |
Accepting new patients |
| Hartford Healthcare Medical Group, Inc | Past |
Accepting new patients |
Locations
55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 79071 | CT | Yes |
Addresses
Primary practice location
5 Dayton Rd Ste 102
Waterford, CT 06385-4279
Mailing address
1290 Silas Deane Highway
HHC - Cvo
Wethersfield, CT 06109-4337
Other providers in Waterford, CT
- Valerie Rose Adomaitis
- Advanced Options, LLC
- Amanda Tegan Ahlcrona
- Ajlr Dental Associates PC
- Alchemic Healing, LLC
- Allegheny Foot & Ankle Center, LLC
- Amanda Frechette, LCSW LLC
- Rachelle Andre
- Arlene B. Werner, PH.D.
- Arnold E. Benak Jr. DMD LLC
All providers in Waterford, CT · Family Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.