Individual provider Active NPI

Mitchell Friedman

  • Acute Care Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1851061808
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
10040 Issued in CT
Practice address
19 Woodland St Ste 35
Hartford, CT 06105-2335
Phone
(860) 525-1234
NPI assigned
Sep 20, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 10040 CT Primary

Addresses

Primary practice location

19 Woodland St Ste 35
Hartford, CT 06105-2335

Mailing address

12-3 Countryside LN
Middletown, CT 06457-6005
Phone (203) 217-6876

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
I20220714000400 CT Practitioner - Nurse Practitioner 4587052550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince May 1, 2022 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince May 1, 2022 Accepting new patients

Locations

1699 King St
Ste 404
Enfield, CT 06082
Phone (860) 651-4358

19 Woodland St
Ste 35
Hartford, CT 06105
Phone 20321768760

19 Woodland St
Ste 45
Hartford, CT 06105
Phone (860) 527-1669

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

381 Hopmeadow St
Weatogue, CT 06089
Phone (860) 651-1669

Interoperability endpoints

  • Direct secure messaging: mfriedman2377193@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 3

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": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1851061808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12-3 COUNTRYSIDE LN",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064576005",
            "telephone_number": "203-217-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 WOODLAND ST STE 35",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052335",
            "telephone_number": "860-525-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "MITCHELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "10040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.