Eric James Collentro, PA-C
Individual provider Active NPI Surgical Physician Assistant · Hartford, CT
NPI 1801425442 · NPPES record last updated Nov 8, 2023
Key facts
- NPI
- 1801425442
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 005111 (CT)
- Practice address
- 80 Seymour St
Hartford, CT 06102-8000 - Phone
- (860) 545-5000
- NPI assigned
- Apr 6, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hartford Hospital
Practice addresses (Care Compare)
80 Seymour St
Hartford, CT 06102-8000
Hospital & facility affiliations
- Hartford Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.63 of 100
- Quality
- 75.35
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.44
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210310000801 | CT | Practitioner - Physician Assistant | 3678989084 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005111 | CT | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group Specialists, PLLC | Surgical | Current |
Accepting new patients |
| Hartford Healthcare Medical Group Specialists LLC | Current |
Accepting new patients | |
| Hartford Hospital | Current |
Accepting new patients |
Locations
80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249
1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
Interoperability endpoints
- eric.collentro@xdr.hhchealthdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 005111 | CT | Yes |
Addresses
Primary practice location
80 Seymour St
Hartford, CT 06102-8000
Mailing address
80 Seymour St
Hartford, CT 06102-8000
Phone (860) 545-5000
Other providers in Hartford, CT
- Collaborative Counseling Center, LLC
- Collaborative Laboratory Services LLC
- Collaborative Laboratory Services-Mount Sinai Campus
- Gisel Collazo
- Ileana Collazo
- Bonnie A Colleton
- Lauren Elisabeth Collin
- Collins Medical Associates 2 PC
- Collins Medical Associates 2 PC
- Abigail Collins
All providers in Hartford, CT · Surgical Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.