NPIMap

Individual provider Active NPI

Angela Dawn Qualey, PA-C

  • Medical Physician Assistant
  • Hartford, CT
National Provider Identifier
1710380282
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
003392 Issued in CT
Practice address
80 Seymour St
Hartford Hospital Emergency Department
Hartford, CT 06102-5037
Phone
(860) 972-0000
NPI assigned
Sep 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NC
Physician Assistant 363A00000X 003392 CT
Medical Physician Assistant 363AM0700X 003392 CT Primary
Surgical Physician Assistant 363AS0400X 003392 CT

Addresses

Primary practice location

80 Seymour St
Hartford Hospital Emergency Department
Hartford, CT 06102-5037

Mailing address

80 Seymour St
Hartford Hospital Emergency Department
Hartford, CT 06102-5037
Phone (860) 972-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CT, NY3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20150202002140 NC Practitioner - Physician Assistant 7113242751 Reassigns benefits to 1 organization
I20151117000778 CT Practitioner - Physician Assistant 7113242751 Reassigns benefits to 3 organizations
I20171219002650 NY Practitioner - Physician Assistant 7113242751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford HospitalGroup PAC ID 2567366016, 1,040 clinicians

Practice addresses (Care Compare)

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 545-7500

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003392CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Medical Services of New York PC CurrentSince Sep 24, 2017 Accepting new patients
Hartford Hospital CurrentSince Sep 28, 2015 Accepting new patients
Nes Medical Services of New York PC CurrentSince Sep 24, 2017 Accepting new patients

Locations

7571 State Route 54
Bath, NY 14810
Phone (607) 776-8500

Organizations & group practices 8

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 2

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": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1710380282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "address_2": "HARTFORD HOSPITAL EMERGENCY DEPARTMENT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-972-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "address_2": "HARTFORD HOSPITAL EMERGENCY DEPARTMENT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-972-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUALEY",
        "first_name": "ANGELA",
        "middle_name": "DAWN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-29",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "003392",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "003392",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "003392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.