Individual provider Active NPI

Mary Maria Naccarato

  • Medical Physician Assistant
  • Prospect, CT
National Provider Identifier
1871279315
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
166 Waterbury Rd
Prospect, CT 06712-1200
Phone
(203) 709-5300
Fax
(203) 709-5348
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

166 Waterbury Rd
Prospect, CT 06712-1200

Mailing address

9 Kovacs PL
Wallingford, CT 06492-3163

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
I20240320000638 CT Practitioner - Physician Assistant 8628415130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208

1154 Highland Ave
Cheshire, CT 06410-1662
Phone (860) 714-6318

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jan 14, 2024 Accepting new patients

Locations

1154 Highland Ave
Cheshire, CT 06410
Phone (203) 679-3533

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

166 Waterbury Rd
Ste 300
Prospect, CT 06712
Phone (203) 709-5300

1598 E Main St
Torrington, CT 06790
Phone (860) 489-8444

Interoperability endpoints

  • Direct secure messaging: mnaccarato3102250@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 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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1871279315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 KOVACS PL",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 WATERBURY RD",
            "city": "PROSPECT",
            "state": "CT",
            "postal_code": "067121200",
            "telephone_number": "203-709-5300",
            "fax_number": "203-709-5348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACCARATO",
        "first_name": "MARY",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prospect, CT

Sources for this page

Verify at the official NPI Registry.