Individual provider Active NPI

Loretta Johnson Pilagin, M.D.

  • Family Medicine Physician
  • Manchester, CT
National Provider Identifier
1811965833
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2014-02093 Issued in NC
Practice address
375 E Center St
Manchester, CT 06040-4445
Phone
(860) 646-0166
Fax
(860) 645-7534
NPI assigned
Mar 8, 2006
Last updated
Jan 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 032428 CT
Family Medicine Physician 207Q00000X 2014-02093 NC Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170206000026 NC Practitioner - Family Practice 5799874053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032428CTMDFamily Medicine Physician
2014-02093NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wilkes Physician Network, Inc. Family Medicine Current Accepting new patients
Saint Francis Behavioral Health Group, P.C. PastSince Apr 1, 2014 Accepting new patients
Healthwise Medical Associates, LLP Family Medicine Past Accepting new patients

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1811965833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3249",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060662149",
            "telephone_number": "860-872-2289",
            "fax_number": "860-896-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404445",
            "telephone_number": "860-646-0166",
            "fax_number": "860-645-7534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILAGIN",
        "first_name": "LORETTA",
        "middle_name": "JOHNSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "032428",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2014-02093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.