Individual provider Active NPI

Josee Diane Cloutier, M.D.

  • Family Medicine Physician
  • Groton, CT
National Provider Identifier
1790860419
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
040820 Issued in CT
Practice address
1 Wahoo Ave
Groton, CT 06349-2324
Phone
(860) 694-1523
NPI assigned
Oct 25, 2006
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 040820 CT Primary

Addresses

Primary practice location

1 Wahoo Ave
Groton, CT 06349-2324

Mailing address

3 Highwood Rd
Niantic, CT 06357-1808
Phone (860) 389-2546

Other practice location 1

23 Church Ln # C
East Lyme, CT 06333-1621
Phone (860) 758-7888

Other identifiers 8

IdentifierTypeStateIssuer
040820OtherCTCONNECTICARE
3581342OtherCTAETNA
5534978OtherCTFIRST HEALTH
2V4806OtherCTHEALTH NET
P2706722OtherCTOXFORD
134273740OtherCTCOMMERCIAL PLANS
9727325OtherCTCIGNA
010040820CT02OtherCTANTHEM BLUE CROSS

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
I20040430000587 CT Practitioner - Family Practice 2769479617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

131 Boston Post Rd
Suite 14
East Lyme, CT 06333-1605
Phone (860) 691-0302

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040820CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Hospitalists of New England PC Family Medicine CurrentSince Nov 18, 2009 Accepting new patients
Ipc Hospitalists of New England, P.C. Family Medicine CurrentSince Nov 18, 2009 Accepting new patients
Hartford Healthcare Medical Group, Inc Family Medicine PastSince Jan 1, 2021 Accepting new patients
WRK Ventures, LLC Past Accepting new patients

Locations

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

365 Montauk Ave
Rm 4
New London, CT 06320

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHADCD/Endpoint/AHADCD

Organizations & group practices 5

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 2

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1790860419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HIGHWOOD RD",
            "city": "NIANTIC",
            "state": "CT",
            "postal_code": "063571808",
            "telephone_number": "860-389-2546",
            "fax_number": "860-365-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WAHOO AVE",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063492324",
            "telephone_number": "860-694-1523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23 Church Ln # C",
            "address_purpose": "LOCATION",
            "city": "East Lyme",
            "state": "CT",
            "postal_code": "063331621",
            "country_code": "US",
            "telephone_number": "860-758-7888",
            "fax_number": "860-365-6961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLOUTIER",
        "first_name": "JOSEE",
        "middle_name": "DIANE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "040820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "040820",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3581342",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "5534978",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2V4806",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2706722",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL PLANS",
            "identifier": "134273740",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9727325",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "010040820CT02",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

Verify at the official NPI Registry.