Active NPI
Amanda Marie Pacheco, APRN
- Family Nurse Practitioner
- Hartford, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 12.007706
- Practice address
- 114 Woodland St
Hartford, CT 06105-1208 - Phone
- (860) 714-4270
- NPI assigned
- Jul 24, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.0042322 | OH | |
| Family Nurse Practitioner | 363LF0000X | 12.007706 | CT | Primary |
| Family Nurse Practitioner | 363LF0000X | 4704448904 | MI |
Addresses
Primary practice location
114 Woodland St
Hartford, CT 06105-1208
Mailing address
505 Buckland Dr
Cheshire, CT 06410-4153
Phone (203) 233-8935
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT, MI, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
200 Oceangate
Suite 100
Long Beach, CA 90802-4316
505 Buckland Dr
Cheshire, CT 06410-4153
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12.007706 | CT | MD | Family Nurse Practitioner |
| 4704448904 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Molina Care Connections, LLC. | Current | Accepting new patients |
Locations
200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666
175 Scott Swamp Rd
Farmington, CT 06032
Phone (860) 249-6752
880 W Long Lake Rd
Troy, MI 48098
Phone (248) 227-6316
3000 Corporate Exchange Dr
Columbus, OH 43231
Phone (614) 942-3042
Interoperability endpoints
- ms_apache30@landmarkhealth-direct.org
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781481600000",
"number": "1881171635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 BUCKLAND DR",
"city": "CHESHIRE",
"state": "CT",
"postal_code": "064104153",
"telephone_number": "203-233-8935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 WOODLAND ST",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061051208",
"telephone_number": "860-714-4270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACHECO",
"first_name": "AMANDA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-24",
"last_updated": "2026-06-15",
"certification_date": "2026-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "APRN.CNP.0042322",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "12.007706",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704448904",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.