Individual provider Active NPI

Emmanuel Javier, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Hartford, CT
National Provider Identifier
1740283779
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
028901 Issued in CT
Practice address
1000 Asylum Ave
Suite 4310
Hartford, CT 06105-1770
Phone
(860) 247-2137
Fax
(860) 728-0480
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 028901 CT Primary

Addresses

Primary practice location

1000 Asylum Ave
Suite 4310
Hartford, CT 06105-1770

Mailing address

30 Jordan LN
Wethersfield, CT 06109-1278
Phone (860) 263-0253

Other identifiers 1

IdentifierTypeStateIssuer
001289017MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150514000402 MI Practitioner - Internal MedicinePractitioner - Endocrinology 4486831138 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028901CTMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association CurrentSince Jun 8, 2015 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Prime Healthcare (Sleep Lab) Past Accepting new patients
Prime Healthcare, PC Internal Medicine Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

2900 Hannah Blvd
Ste 114
East Lansing, MI 48823
Phone (517) 364-8080

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1200 E Michigan Ave
Ste 245A
Lansing, MI 48912
Phone (517) 364-5710

Interoperability endpoints

  • Direct secure messaging: ejavier39827@sparrowdirecthie.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1740283779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 JORDAN LN",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091278",
            "telephone_number": "860-263-0253",
            "fax_number": "860-263-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE",
            "address_2": "SUITE 4310",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051770",
            "telephone_number": "860-247-2137",
            "fax_number": "860-728-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVIER",
        "first_name": "EMMANUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CT",
            "license": "028901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001289017",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.