Mary Catherine D'Amico, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

5515 Issued in CT

Practice address

71 Westcott Rd
Danielson, CT 06239-2929

Phone

(860) 774-7179

Fax

(860) 779-6526

NPI assigned

Sep 11, 2013

Last updated

Apr 24, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mary Tebo Former name

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

Specialty

Nurse Practitioner

Education

University of Connecticut School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marydamico@mpp.allscriptsdirect.net

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.

• Prospect CT Medical Foundation, Inc.

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1144677568
  Medicare reassignment Care Compare group NPD
• Community Health Resources, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Windsor, CT
  • NPI 1215979810
  Medicare reassignment NPD
• Community Health Resources, Inc

  • Adult Mental Health Clinic/Center
  • Windsor, CT
  • NPI 1295800795
  NPD
• Healthwise Medical Associates, LLP

  • Family Medicine Physician
  • Vernon, CT
  • NPI 1891749933
  NPD
• Medical Access P.C.

  dba Tru Urgent Care DMV

  • Urgent Care Clinic/Center
  • Germantown, MD
  • NPI 1144291204
  NPD
• Community Health Resources, Inc.

  • Primary Care Clinic/Center
  • Enfield, CT
  • NPI 1346700093
  NPD (past)

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

• Manchester Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Manchester, CT
  • NPI 1881564664
  Care Compare affiliation

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1710312533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WATERSIDE XING STE 401",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951587",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 WESTCOTT RD",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062392929",
            "telephone_number": "860-774-7179",
            "fax_number": "860-779-6526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 Hazard Ave Ste 401",
            "address_purpose": "LOCATION",
            "city": "Enfield",
            "state": "CT",
            "postal_code": "060824592",
            "country_code": "US",
            "telephone_number": "860-253-5020",
            "fax_number": "860-253-5030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "444 Center St",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060403926",
            "country_code": "US",
            "telephone_number": "860-646-3888",
            "fax_number": "860-731-5536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "D'AMICO",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-11",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "5515",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "005515",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CT",
            "license": "005515",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "TEBO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Colonial Care of Danielson LLC
• Linda Susan Comeau, LMFT
• Jasmin H Conley
• Megan Kathleen Corrado
• Alysha Crouse, LMSW
• Daniels Pharmacy Inc (Daniels Pharmacy)
• Danielson Medical Associates, P.C.
• Danielson Pharmacy Inc (Bonneville Pharmacy and Home Care)
• Danielson Pharmacy Inc (Bonneville LTC)
• Danielson Pharmacy LLC (Danielson pharmacy)

• Adult Health Nurse Practitioner in Danielson, CT
• Providers in Danielson, CT by specialty
• Adult Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.