Individual provider Active NPI

Marjorie A Garrett, MD

  • Internal Medicine Physician
  • Manchester, CT
National Provider Identifier
1710955935
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
038384 Issued in CT
Practice address
945 Main St
Suite 102
Manchester, CT 06040-6064
Phone
(860) 643-0319
Fax
(860) 812-0310
NPI assigned
Mar 14, 2006
Last updated
Jun 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 038384 CT Primary

Addresses

Primary practice location

945 Main St
Suite 102
Manchester, CT 06040-6064

Mailing address

945 Main St
Suite 102
Manchester, CT 06040-6064
Phone (860) 643-0319

Other identifiers 7

IdentifierTypeStateIssuer
001383843MedicaidCT
7884165OtherCTAETNA
010038384CT02OtherCTANTHEM BLUE CROSS BLUE SH
OV9470OtherCTHEALTHNET
P2097199OtherCTOXFORD
038384OtherCTCONNECTICARE
6256332OtherCTCIGNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgarrett31541@direct.stfranciscare.org Direct

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
I20080326000611 CT Practitioner - Internal Medicine 9537245865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Connecticut School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heritage Internal Medicine Associates LLCGroup PAC ID 2365528791, 6 clinicians

Practice addresses (Care Compare)

945 Main St
Suite 102
Manchester, CT 06040-6036
Phone (860) 643-0319

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
038384CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Internal Medicine Associates LLC Internal Medicine CurrentSince Mar 1, 2008 Accepting new patients

Locations

95 Woodland St
Fl 1
Hartford, CT 06105
Phone (860) 714-7362

945 Main St
Ste 102
Manchester, CT 06040
Phone (860) 643-0319

Interoperability endpoints

  • Direct secure messaging: marjorie.garrett.1@27673.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1710955935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 MAIN ST",
            "address_2": "SUITE 102",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406064",
            "telephone_number": "860-643-0319",
            "fax_number": "860-812-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 MAIN ST",
            "address_2": "SUITE 102",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406064",
            "telephone_number": "860-643-0319",
            "fax_number": "860-812-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "MARJORIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "038384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001383843",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7884165",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "010038384CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "OV9470",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2097199",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "038384",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6256332",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgarrett31541@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Heritage Internal Medicine Associates Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "945 Main St",
            "address_2": "Suite 102",
            "city": "Manchester",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060406064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.