Hartford Hospital
Organization Active NPI Psychiatric Hospital Unit · Hartford, CT
NPI 1861652604 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1861652604
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- License
- 0046 (CT)
- Legal business name
- HARTFORD HOSPITAL
- Practice address
- 80 Seymour St
Hartford, CT 06102-8000 - Phone
- (860) 696-6010
- Fax
- (860) 696-6190
- NPI assigned
- Jun 16, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Thomas Marchozzi
- Title
- VP Finance
- Phone
- (860) 545-2746
Owners & managing parties with NPI records 7
-
Michael T. O'Loughlin, M.D.
-
Matthew Saidel, MD
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 11
Related certifications (CCN) 2
Facilities with the same owner 17
Practitioners 1,040
-
Lincoln F Abbott, MD
-
Olurotimi Olusegun Adekolu, M.B.CH.B
-
Amelia Kay Ahern, PA-C
-
Zain Ahmed, M.D.
-
Areej Al Siaghy, MD
-
Todd J Alekshun, M.D.
-
Jeffrey Stephen Alger, ACNPC-AG
-
Lindsay Alger, PA-C
-
Syed Musadiq Ali, MD
-
Betsy Alvarado, PA
-
Sarah Lisette Amenta, APRN-BC
-
Hardik P Amin, M.D.
-
Stephen Marc Amrock, M.D.
-
Chan Andries, PA-C
-
Paul Robert Anthony Jr., M.D.
-
Sabeena Arora, MBBS
-
Syed Daniyal Asad, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Hospital certification: CCN 07S025
- Legal name
- HARTFORD HOSPITAL
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 1, 1854 in CT
- Enrollment address
- 200 Retreat Ave
Hartford, CT 61063309 - Hospital subgroups
- General, Psychiatric unit
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Gerald Boisvert |
Corporate Officer |
Oct 1, 2013 | |
| W-2 Managing Employee |
Oct 1, 2013 | ||
| Operational/Managerial Control |
Oct 1, 2013 | ||
| Eric Zachs |
Corporate Director |
Jan 3, 2019 | |
| Hartford Hospital |
Operational/Managerial Control | Jul 1, 1966 | 100% |
| Yvette Melendez |
Corporate Director |
Jan 3, 2019 | |
| Matthew L Saidel |
Corporate Director |
Jan 3, 2019 | |
| Michael Oloughlin |
Corporate Director |
Jan 3, 2019 | |
| Arnold Case |
Corporate Director |
Jan 3, 2019 | |
| Brian Maclean |
Corporate Director |
Jan 3, 2019 | |
| Alexia Cruz |
Corporate Director |
Jan 3, 2019 | |
| Hartford Healthcare Corporation |
5% Or Greater Indirect Ownership Interest | Jan 1, 2009 | |
| Operational/Managerial Control | Jan 1, 2009 | ||
| E Carol Polifroni |
Corporate Director |
Jan 3, 2019 | |
| Dariush Owlia |
Corporate Director |
Jan 3, 2019 | |
| James Loree |
Corporate Director |
Jan 3, 2019 | |
| Elease Wright |
Corporate Director |
Jan 3, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120319000029 | CT | Part a Provider - Hospital | 2567366016 | Practice locations: Glastonbury, CT; Wethersfield, CT; West Hartford, CT; Vernon, CT; Hartford, CT; Enfield, CT; Cheshire, CT; Avon, CT |
National Provider Directory
- Tax ID family
- Jennifer L Dauphinais
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | 0046 | CT | Yes |
Addresses
Primary practice location
80 Seymour St
Hartford, CT 06102-8000
Mailing address
80 Seymour St
Hartford, CT 06102-8000
Phone (860) 696-6010
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C001897 | Other | CT | TRICARE |
| IS10001 | Other | CT | HEALTHNET |
| 059672 | Other | CT | VALUE OPTIONS |
| 0001352 | Other | CT | US HEALTHCARE |
| 0319896 | Other | CT | UNITED HEALTHCARE |
| 038157400 | Other | CT | FEDERAL BLACK LUNG PROGRAM |
| 900006 | Other | CT | CTCARE |
| 0006170150 | Other | CT | AETNA |
| C00023 | Other | CT | MEDICARE PART B |
| 004041869 | Medicaid | CT | |
| 005 | Other | CT | ANTHEM BLUE CROSS |
| 900777 | Other | CT | TUFTS INSURANCE |
| H01316 | Other | CT | OXFORD |
| 05B | Other | CT | ANTHEM BLUE CROSS MH |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other |
Other providers in Hartford, CT
- Hartford Hospital
- Hartford Hospital
- Hartford Hospital
- Hartford Hospital
- Hartford Hospital
- Hartford Hospital
- Hartford Hospital
- Hartford Hospital Pharmacy
- Hartford Knights Corp
- Hartford Neurology, LLC
All providers in Hartford, CT · Psychiatric Hospital Unit in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.