Individual provider Active NPI

Phillip Y. Roland, MD

  • Gynecologic Oncology Physician
  • Hartford, CT
National Provider Identifier
1780679969
Registry record updated Nov 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
046991 Issued in CT
Practice address
1000 Asylum Ave
Suite 2110
Hartford, CT 06105-1770
Phone
(860) 714-7945
Fax
(860) 714-8880
NPI assigned
Sep 14, 2005
Last updated
Nov 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X ME0080439 FL
Gynecologic Oncology Physician 207VX0201X 046991 CT Primary

Addresses

Primary practice location

1000 Asylum Ave
Suite 2110
Hartford, CT 06105-1770

Mailing address

1000 Asylum Ave
Suite 2109a
Hartford, CT 06105-1770
Phone (860) 714-7945

Other identifiers 8

IdentifierTypeStateIssuer
2541920OtherFLAETNA PROVIDER NUMBER
259334300MedicaidFL
3503291-002OtherFLCIGNA PROVIDER NUMBER
5250568OtherFLAETNA OTHER PROV. #
851882OtherFLFIRST HEALTH PROVIDER #
35479OtherFLBCBS OF FL. PROVIDER #
36-00184OtherFLUTD. HLTHCR. PROVIDER #
920005669OtherFLRAILROAD MEDICARE

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
I20090529000208 CT Practitioner - Gynecological Oncology 3274682950 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046991CTMDGynecologic Oncology Physician
ME0080439FLMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc Gynecologic Oncology CurrentSince Apr 1, 2009 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Apr 1, 2009 Accepting new patients
Saint Francis Care Medical Group, PC Past Accepting new patients

Locations

1000 Asylum Ave
Ste 2110
Hartford, CT 06105
Phone (860) 714-4508

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

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448409600000",
    "number": "1780679969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE",
            "address_2": "SUITE 2109A",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051770",
            "telephone_number": "860-714-7945",
            "fax_number": "860-714-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE",
            "address_2": "SUITE 2110",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051770",
            "telephone_number": "860-714-7945",
            "fax_number": "860-714-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLAND",
        "first_name": "PHILLIP",
        "middle_name": "Y.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2015-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "FL",
            "license": "ME0080439",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "CT",
            "license": "046991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "2541920",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259334300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "3503291-002",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA OTHER PROV. #",
            "identifier": "5250568",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH PROVIDER #",
            "identifier": "851882",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL. PROVIDER #",
            "identifier": "35479",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTD. HLTHCR. PROVIDER #",
            "identifier": "36-00184",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "920005669",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.