Loretta Johnson Pilagin, M.D.
Individual provider Active NPI Family Medicine Physician · Manchester, CT
NPI 1811965833 · NPPES record last updated Jan 4, 2017
Key facts
- NPI
- 1811965833
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2014-02093 (NC)
- Practice address
- 375 E Center St
Manchester, CT 06040-4445 - Phone
- (860) 646-0166
- Fax
- (860) 645-7534
- NPI assigned
- Mar 8, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170206000026 | NC | Practitioner - Family Practice | 5799874053 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032428 | CT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wilkes Physician Network, Inc. | Family Medicine | Current | Accepting new patients |
| Saint Francis Behavioral Health Group, P.C. | Past |
Accepting new patients | |
| Healthwise Medical Associates, LLP | Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 032428 | CT | |
| Family Medicine Physician | 207Q00000X | 2014-02093 | NC | Yes |
Addresses
Primary practice location
375 E Center St
Manchester, CT 06040-4445
Mailing address
PO Box 3249
Vernon, CT 06066-2149
Phone (860) 872-2289
Other providers in Manchester, CT
- Krystle B Pierce
- Mackenzie Pierce
- John Anthony Pietropaoli Jr.
- Barbarita Pieve
- Toniann B Pike
- Pine Lenox Pharmacy Inc
- Diana Pereira Pinho
- Pink Couch Therapy
- Courtney Pinner
- Jolene Piscetello
All providers in Manchester, CT · Family Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2017. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.