Individual provider Active NPI

Mirela Nicolescu, MD

  • Rheumatology Physician
  • Waterbury, CT
National Provider Identifier
1750601985
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
55368 Issued in CT
Practice address
3801 E Main St
Waterbury, CT 06705-3815
Phone
(203) 709-6855
Fax
(203) 709-5239
NPI assigned
Jun 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Rheumatology Physician 207RR0500X 55368 CT Primary

Addresses

Primary practice location

3801 E Main St
Waterbury, CT 06705-3815

Mailing address

3801 E Main St
Waterbury, CT 06705-3815
Phone (203) 709-6855

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mnicolescu62845@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
I20160916000101 CT Practitioner - Rheumatology 2567690266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

56 Franklin St
Waterbury, CT 06706-1253
Phone (203) 709-6000

Hospital & facility affiliations

  • Saint Mary'S Hospital Hospital, Waterbury, CT, CCN 070016

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Rheumatology CurrentSince Dec 19, 2021 Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

166 Waterbury Rd
Ste 300
Prospect, CT 06712
Phone (203) 709-5300

Interoperability endpoints

  • Direct secure messaging: mnicolescu2389624@direct.trinity-health.org

Organizations & group practices 2

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 1

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": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1750601985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067053815",
            "telephone_number": "203-709-6855",
            "fax_number": "203-709-5239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067053815",
            "telephone_number": "203-709-6855",
            "fax_number": "203-709-5239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLESCU",
        "first_name": "MIRELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CT",
            "license": "55368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnicolescu62845@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3801 E Main St",
            "city": "Waterbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "067053815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.