Individual provider Active NPI

Jose Morales-Marin, PA

  • Physician Assistant
  • Hartford, CT
National Provider Identifier
1821090432
Registry record updated Feb 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000635 Issued in CT
Practice address
94 Woodland St
Cancer Center
Hartford, CT 06105-1217
Phone
(860) 714-4680
Fax
(860) 714-8047
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000635 CT Primary

Addresses

Primary practice location

94 Woodland St
Cancer Center
Hartford, CT 06105-1217

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 CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100218000378 CT Practitioner - Physician Assistant 1153465828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208

142 Hazard Ave
Enfield, CT 06082-4520
Phone (860) 272-2911

148 Hazard Ave
Enfield, CT 06082-4520
Phone (860) 714-2647

Hospital & facility affiliations

  • St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002
  • Johnson Memorial Hospital Hospital, Stafford Springs, CT, CCN 070008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
635CTMDPhysical Therapy Assistant
000635CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jun 26, 2000 Accepting new patients

Locations

1000 Asylum Ave
Ste 4304
Hartford, CT 06105
Phone (860) 522-3711

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

94 Woodland St
Hartford, CT 06105
Phone (860) 714-4568

Interoperability endpoints

  • Direct secure messaging: jmoralesmarin85134@direct.trinity-health.org

Organizations & group practices 2

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 6

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235692800000",
    "number": "1821090432",
    "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": "94 WOODLAND ST",
            "address_2": "CANCER CENTER",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051217",
            "telephone_number": "860-714-4680",
            "fax_number": "860-714-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES-MARIN",
        "first_name": "JOSE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2009-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.