Active NPI
Michele B. Conlon, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Manchester, CT
National Provider Identifier
1851356208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 025761
- Practice address
- 71 Haynes St
Manchester, CT 06040-4131 - Phone
- (860) 647-6487
- Fax
- (860) 647-6447
- NPI assigned
- Apr 19, 2006
- Last updated
- Oct 24, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 025761 | CT | Primary |
Addresses
Primary practice location
71 Haynes St
Manchester, CT 06040-4131
Mailing address
PO Box 206
New Haven, CT 06501-0206
Phone (203) 397-8000
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004312983 | Other | CT | AETNA |
| 500HBL161CT02 | Other | CT | BC/BS GRP# RGH |
| A524580 | Other | CT | OXFORD |
| W1H29 | Other | CT | EMPIRE BC |
| 76164901 | Other | CT | CTCARE |
| 500HBL161CT01 | Other | CT | BC/BS GRP# |
| 001257618 | Medicaid | CT | |
| 01025761 | Other | CT | CIGNA |
| 1104296 | Other | CT | UHC |
| C009784 | Other | CT | CHAMPUS/TRICARE |
| OR4388 | Other | CT | HLTHNET |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025761 | CT | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern Connecticut Pathology Consultants, P.C. | Anatomic Pathology & Clinical Pathology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- NPI 1346363215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414108800000",
"number": "1851356208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 206",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065010206",
"telephone_number": "203-397-8000",
"fax_number": "203-389-1540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 HAYNES ST",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060404131",
"telephone_number": "860-647-6487",
"fax_number": "860-647-6447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLON",
"first_name": "MICHELE",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-19",
"last_updated": "2014-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "CT",
"license": "025761",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0004312983",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS GRP# RGH",
"identifier": "500HBL161CT02",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "A524580",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC",
"identifier": "W1H29",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CTCARE",
"identifier": "76164901",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS GRP#",
"identifier": "500HBL161CT01",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001257618",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "01025761",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "1104296",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS/TRICARE",
"identifier": "C009784",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HLTHNET",
"identifier": "OR4388",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.