NPIMap

Individual provider Active NPI

Mirlene Polycarpe, FNP, DNP

  • Family Nurse Practitioner
  • Middletown, CT
National Provider Identifier
1821667452
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9761 Issued in CT
Practice address
50 Eastbury Hill Dr
Middletown, CT 06457-8755
Phone
(860) 834-0479
NPI assigned
Jun 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9761 CT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

50 Eastbury Hill Dr
Middletown, CT 06457-8755

Mailing address

85 Retreat Avenue
Hhcmg/Cancer Center/Hartford Hospital
Hartford, CT 06106-2555
Phone (860) 972-4183

Other practice location 1

4000 Park Ave
Bridgeport, CT 06604-1047
Phone (203) 371-7999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230613002052 CT Practitioner - Nurse Practitioner 5294192852 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The William W Backus HospitalGroup PAC ID 0749170645, 248 clinicians
Hartford HospitalGroup PAC ID 2567366016, shared by 6 NPIs, 1,040 clinicians

Practice addresses (Care Compare)

326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331

80 Seymour St
Hartford, CT 06102-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The William W Backus Hospital Current Accepting new patients
Hartford Hospital CurrentSince May 8, 2023 Accepting new patients
Hartford Hospital CurrentSince May 8, 2023 Accepting new patients
Hartford Hospital CurrentSince Jul 30, 2023 Accepting new patients
William W Backus Hospital CurrentSince Sep 22, 2023 Accepting new patients
The William W Backus Hospital Family Past Accepting new patients

Locations

85 Retreat Ave
Hartford, CT 06106
Phone (860) 249-6291

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: mirlene.polycarpe@xdr.hhchealthdirect.org

Organizations & group practices 6

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 5

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": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1821667452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 RETREAT AVENUE",
            "address_2": "HHCMG/CANCER CENTER/HARTFORD HOSPITAL",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062555",
            "telephone_number": "860-972-4183",
            "fax_number": "860-972-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 EASTBURY HILL DR",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064578755",
            "telephone_number": "860-834-0479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066041047",
            "country_code": "US",
            "telephone_number": "203-371-7999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLYCARPE",
        "first_name": "MIRLENE",
        "name_prefix": "Mrs.",
        "credential": "FNP, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "9761",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.