Individual provider Active NPI

Mary Beth Campbell, NP-C

  • Nurse Practitioner
  • Bridgeport, CT
National Provider Identifier
1861676173
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
004930 Issued in CT
Practice address
2800 Main St
Hospitalist Dept
Bridgeport, CT 06606-4201
Phone
(203) 576-6000
NPI assigned
Dec 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 235123 MA
Nurse Practitioner 363L00000X 004930 CT Primary

Addresses

Primary practice location

2800 Main St
Hospitalist Dept
Bridgeport, CT 06606-4201

Mailing address

2800 Main St
St. Vincent Multispecialty Group
Bridgeport, CT 06606-4201
Phone (203) 576-6000

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
I20150731016051 CT Practitioner - Nurse Practitioner 6103993399 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

2800 Main St
Bridgeport, CT 06606-4201
Phone (475) 210-5242

Hospital & facility affiliations

  • St Vincent'S Medical Center Hospital, Bridgeport, CT, CCN 070028

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4930CTMDOccupational Therapist
004930CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Dec 1, 2020 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC Nurse Practitioner CurrentSince Dec 1, 2020 Accepting new patients
Neighborhood Health, Inc. Nurse Practitioner CurrentSince Oct 10, 2013 Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

2660 Main St
Ste 216
Bridgeport, CT 06606
Phone (203) 335-0919

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

Interoperability endpoints

  • Direct secure messaging: marybeth.campbell@xdr.hhchealthdirect.org

Organizations & group practices 3

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 1

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": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1861676173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "address_2": "ST. VINCENT MULTISPECIALTY GROUP",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "203-576-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "address_2": "HOSPITALIST DEPT",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "203-576-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MARY BETH",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-21",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "235123",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "004930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.