Philip A. Mongelluzzo Jr., M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

038887 Issued in CT

Practice address

2247 East Main Street
Suite 103
Waterbury, CT 06705

Phone

(203) 757-3486

Fax

(203) 757-3723

NPI assigned

Jan 26, 2006

Last updated

Jun 17, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Creighton University School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Care Beyond Medicine PLLCGroup PAC ID 7315355849, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uconn Health Community Network Home Health, Inc. Home health agency, Watertown, CT, CCN 077085
• Saint Mary's Hospital Hospital, Waterbury, CT, CCN 070016
• Waterbury Hospital Hospital, Waterbury, CT, CCN 070005

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Care Beyond Medicine PLLC

  • Internal Medicine Physician
  • Waterbury, CT
  • NPI 1902481930
  Medicare reassignment Care Compare group Authorized official
• Dr. Philip a. Mongelluzzo, Jr. LLC

  • Internal Medicine Physician
  • Waterbury, CT
  • NPI 1275627093
  Authorized official Same address or phone
• Gaylord Hospital, Inc.

  dba Gaylord Hospital

  • Long Term Care Hospital
  • Wallingford, CT
  • NPI 1730137753
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prospect Waterbury Home Health, Inc.

  dba VNA Health at Home

  • Home Health Agency
  • Watertown, CT
  • NPI 1265880413
  Care Compare affiliation
• Prospect Waterbury, Inc.

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1477902641
  Care Compare affiliation
• Saint Mary's Hospital, Inc.

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1760426969
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1871563247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2247 EAST MAIN STREET",
            "address_2": "SUITE 103",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06705",
            "telephone_number": "203-757-3486",
            "fax_number": "203-757-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2247 EAST MAIN STREET",
            "address_2": "SUITE 103",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06705",
            "telephone_number": "203-757-3486",
            "fax_number": "203-757-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGELLUZZO",
        "first_name": "PHILIP",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "038887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001388877",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004245272",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmongelluzzo42376@direct.stfranciscare.org",
            "affiliation": "N",
            "address_1": "2247 East Main Street",
            "address_2": "Suite 103",
            "city": "Waterbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jazmin Molina, LADC
• Irida Molla, MD
• Katherine Molter
• Monarch Counseling Group, LLC
• Sukhda Monga
• Nancy S Monocchi, LMFT
• Sarah Marie Montavon, APRN
• Kimberly Bella Montefusco, LPC
• Michael Montefusco
• Nicole Montello, PHARMD

• Internal Medicine Physician in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.