Individual provider Active NPI

Marielle J Morgan, PA-C

  • Surgical Physician Assistant
  • Hartford, CT
National Provider Identifier
1790914596
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2577 Issued in CT
Practice address
1000 Asylum Ave
Suite 2118
Hartford, CT 06105-1770
Phone
(860) 714-4440
Fax
(860) 714-8012
NPI assigned
Jul 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1404 MA
Medical Physician Assistant 363AM0700X 2577 CT
Surgical Physician Assistant 363AS0400X 2577 CT Primary

Addresses

Primary practice location

1000 Asylum Ave
Suite 2118
Hartford, CT 06105-1770

Mailing address

1000 Asylum Ave
Suite 2109a
Hartford, CT 06105-1770
Phone (860) 714-6581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090916000332 MA Practitioner - Physician Assistant 5890841894 Reassigns benefits to 1 organization
I20110525000722 CT Practitioner - Physician Assistant 5890841894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208

233 Carew St
Springfield, MA 01104-2377
Phone (413) 748-9212

271 Carew St
Springfield, MA 01104-2377
Phone (413) 748-9000

Hospital & facility affiliations

  • St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002577CTMDMental Health Counselor
1404MAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince May 23, 2011 Accepting new patients
Riverbend Medical Group, Inc CurrentSince Feb 3, 2018 Accepting new patients

Locations

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

1000 Asylum Ave
Ste 4309A
Hartford, CT 06105

233 Carew St
#101
Springfield, MA 01104
Phone (413) 748-9212

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

395 Southampton Rd
Ste 100
Westfield, MA 01085
Phone (413) 485-4661

Interoperability endpoints

  • Direct secure messaging: mmorgan85135@direct.trinity-health.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.

Hospital & facility affiliations 3

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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1790914596",
    "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": "860-714-6581",
            "fax_number": "860-714-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE",
            "address_2": "SUITE 2118",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051770",
            "telephone_number": "860-714-4440",
            "fax_number": "860-714-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "MARIELLE",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "1404",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "2577",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "2577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.