Individual provider Active NPI

Mridula Sree Naagendran, M.B.B.S.

  • Student in an Organized Health Care Education/Training Program
  • New Britain, CT
National Provider Identifier
1902597750
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Outpatient Clinic-Hospital of Central Connecticut
100 Grand Street
New Britain, CT 06050
Phone
(860) 224-5261
Fax
(860) 224-5957
NPI assigned
May 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

Outpatient Clinic-Hospital of Central Connecticut
100 Grand Street
New Britain, CT 06050

Mailing address

Outpatient Clinic-Hospital of Central Connecticut
100 Grand Street
New Britain, CT 06050
Phone (860) 224-5261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20260410002334 GA Order and Referring Only - Allergy/ImmunologyPractitioner - Allergy/Immunology 8123593779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: mnaagendran496181@xdr.hhchealthdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1902597750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "OUTPATIENT CLINIC-HOSPITAL OF CENTRAL CONNECTICUT",
            "address_2": "100 GRAND STREET",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "06050",
            "telephone_number": "860-224-5261",
            "fax_number": "860-224-5957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OUTPATIENT CLINIC-HOSPITAL OF CENTRAL CONNECTICUT",
            "address_2": "100 GRAND STREET",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "06050",
            "telephone_number": "860-224-5261",
            "fax_number": "860-224-5957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAAGENDRAN",
        "first_name": "MRIDULA SREE",
        "credential": "M.B.B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-11-22",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Britain, CT

Sources for this page

Verify at the official NPI Registry.