Gerard George Gagne Jr., M.D.
Individual provider Active NPI Psychiatry Physician · Somers, CT
NPI 1861437477 · NPPES record last updated Aug 13, 2014
Key facts
- NPI
- 1861437477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- MD046464 (CT)
- Practice address
- 287 Bilton Rd
Somers, CT 06071-1044 - Phone
- (860) 763-8716
- Fax
- (860) 763-8779
- NPI assigned
- Jun 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141104000739 | CT | Practitioner - Psychiatry | 2466406277 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD046464 | CT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Natchaug Hospital, Inc. | Current |
Accepting new patients |
Locations
189 Storrs Rd
Mansfield Ctr, CT 06250
Phone (860) 456-1311
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD046464 | CT | Yes |
Addresses
Primary practice location
287 Bilton Rd
Somers, CT 06071-1044
Mailing address
287 Bilton Rd
Somers, CT 06071-1044
Phone (860) 763-8716
Other names
- Gerry Gagne
Other providers in Somers, CT
- Sarah Donahue
- Marcos Molina Donnelly
- Edge Medical Services
- James Patrick Fitzgerald
- Four Town Dental Care, LLC
- Laura Lee Gavlak
- Suzanne Gile
- Carolyn Constance Greenfield
- Kari Ann Guerette
- Jill V. Haga
All providers in Somers, CT · Psychiatry Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.