Natalie Marie Concannon, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5660 Issued in CT

Practice address

5 Dayton Rd Ste 205
Waterford, CT 06385-4279

Phone

(860) 443-4445

Fax

(860) 447-8961

NPI assigned

Apr 22, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Natalie Marie Grome Former name

Medicare fee-for-service enrollment

Enrolled in NY, NJ, CT3 enrollments

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 3

Specialty

Physician Assistant

Education

Yale University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The William W Backus HospitalGroup PAC ID 0749170645, 248 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• William W Backus Hospital Hospital, Norwich, CT, CCN 070024

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: nconcannon40696@mskcc.direct-ci.com

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.

• The William W Backus Hospital

  • General Acute Care Hospital
  • Norwich, CT
  • NPI 1467517235
  Medicare reassignment Care Compare group NPD
• Memorial Hematology Lymphoma Group

  • Hematology & Oncology Physician
  • New York, NY
  • NPI 1891766366
  Medicare reassignment NPD
• Memorial Sloan Kettering Cancer Center at Basking Ridge New Jersey

  • Medical Oncology Physician
  • Basking Ridge, NJ
  • NPI 1184637886
  Medicare reassignment
• MSK Bergen

  • Medical Oncology Physician
  • Montvale, NJ
  • NPI 1558814657
  Medicare reassignment
• MSK Monmouth

  • Medical Oncology Physician
  • Middletown, NJ
  • NPI 1922459163
  Medicare reassignment
• The William W Backus Hospital

  • General Acute Care Hospital
  • Norwich, CT
  • NPI 1639135718
  NPD
• William W Backus Hospital

  • Psychiatric Hospital Unit
  • Norwich, CT
  • NPI 1730243536
  NPD
• Minnesota Oncology Hematology, PA

  • Hematology & Oncology Physician
  • Saint Paul, MN
  • NPI 1528035995

  Medical

  NPD (past)

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

• The William W Backus Hospital

  • General Acute Care Hospital
  • Norwich, CT
  • NPI 1467517235
  Care Compare affiliation
• The William W Backus Hospital

  • General Acute Care Hospital
  • Norwich, CT
  • NPI 1639135718
  Care Compare affiliation
• William W Backus Hospital

  • Psychiatric Hospital Unit
  • Norwich, CT
  • NPI 1730243536
  Care Compare affiliation

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1720422645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 MOUNTAINVIEW BLVD",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079203444",
            "telephone_number": "908-542-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DAYTON RD STE 205",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063854279",
            "telephone_number": "860-443-4445",
            "fax_number": "860-447-8961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 E 26th St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554044526",
            "country_code": "US",
            "telephone_number": "612-884-6300",
            "fax_number": "612-884-6363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "910 E 26th St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55404",
            "country_code": "US",
            "telephone_number": "612-884-6300",
            "fax_number": "612-884-6363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONCANNON",
        "first_name": "NATALIE",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00473600",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "5660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATALIE",
            "last_name": "GROME",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Medical Physician Assistant in Waterford, CT
• Providers in Waterford, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.