Individual provider Active NPI

Theresa M Caputo, MD

  • Internal Medicine Physician
  • Lebanon, NH
National Provider Identifier
1740259886
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
022902 Issued in CT
Practice address
1 Medical Center Dr
Lebanon, NH 03756-0001
Phone
(603) 650-5922
NPI assigned
Mar 14, 2006
Last updated
Mar 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22420 NH
Internal Medicine Physician 207R00000X 022902 CT Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-0001

Mailing address

130 Hartford Rd
Manchester, CT 06040-5921
Phone (860) 533-4673

Other practice location 1

130 Hartford Rd
Manchester, CT 06040-5921
Phone (860) 533-4673

Other identifiers 1

IdentifierTypeStateIssuer
001229020MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100329001017 CT Practitioner - Internal Medicine 0143219188 Reassigns benefits to 2 organizations
I20220322001851 NH Practitioner - Internal Medicine 0143219188 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Massachusetts Medical School, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

130 Hartford Rd
Manchester, CT 06040-5921
Phone (860) 533-4673

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Access P.C. Current Accepting new patients
Dartmouth-Hitchcock Clinic Internal Medicine CurrentSince Mar 10, 2022 Accepting new patients
Prospect CT Medical Foundation, Inc. Internal Medicine CurrentSince Dec 1, 2021 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Mar 10, 2022 Accepting new patients
Mary Hitchcock Memorial Hospital Internal Medicine CurrentSince Mar 10, 2022 Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

130 Hartford Rd
Manchester, CT 06040
Phone (860) 533-4673

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

29 Haynes St
Ste D
Manchester, CT 06040
Phone (860) 533-4678

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

6 Fieldstone Cmns
Ste D
Tolland, CT 06084
Phone (860) 871-6710

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Interoperability endpoints

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

Organizations & group practices 6

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 3

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": "1646870400000",
    "number": "1740259886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HARTFORD RD",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405921",
            "telephone_number": "860-533-4673",
            "fax_number": "860-812-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-5922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Hartford Rd",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060405921",
            "country_code": "US",
            "telephone_number": "860-533-4673",
            "fax_number": "860-812-0305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAPUTO",
        "first_name": "THERESA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "22420",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "022902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001229020",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.