NPIMap

Individual provider Active NPI

Nieves Hornbeck, M.D.

  • Family Medicine Physician
  • Hartford, CT
National Provider Identifier
1780635771
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
045400 Issued in CT
Practice address
21 Grand St
Hartford, CT 06106-1541
Phone
(860) 550-7500
Fax
(860) 550-7561
NPI assigned
May 13, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G79482 CA
Family Medicine Physician 207Q00000X 045400 CT Primary

Addresses

Primary practice location

21 Grand St
Hartford, CT 06106-1541

Mailing address

21 Grand St.
Hartford, CT 06106
Phone (860) 550-7500

Other names 1

  • Miss Nieves Lopez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080401000043 CT Practitioner - Family Practice 0648249862 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Geffen School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

300 Wolcott Rd
Wolcott, CT 06716-2614
Phone (203) 879-8003

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G79482CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Oct 4, 2021 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Oct 4, 2021 Accepting new patients
Prospect CT Medical Foundation, Inc. Family Medicine CurrentSince Dec 5, 2022 Accepting new patients
Charter Oak Health Center, Inc. CurrentSince Feb 1, 2015 Accepting new patients
Charter Oak Health Center, Inc. CurrentSince Feb 1, 2015 Accepting new patients
Hartford Physician Services PC Family Medicine Past Accepting new patients
Talbert Medical Group, P.C. Family Medicine Past Accepting new patients
Long River Physicians, LLC Past Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

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

21 Grand St
Hartford, CT 06106

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

205 S Main St
Thomaston, CT 06787
Phone (860) 283-6255

2 Concorde Way
Bldg 2
Windsor Locks, CT 06096
Phone (860) 242-8756

300 Wolcott Rd
Wolcott, CT 06716
Phone (203) 879-8003

Interoperability endpoints

  • Direct secure messaging: nieveshornbeck@amggw.allscriptsdirect.net

Organizations & group practices 8

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 4

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1780635771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GRAND ST.",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06106",
            "telephone_number": "860-550-7500",
            "fax_number": "860-550-7561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GRAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061061541",
            "telephone_number": "860-550-7500",
            "fax_number": "860-550-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNBECK",
        "first_name": "NIEVES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G79482",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "045400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIEVES",
            "last_name": "LOPEZ",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.