Individual provider Active NPI

Marc John Scheublin, M.D.

  • Psychiatry Physician
  • Middletown, CT
National Provider Identifier
1902966997
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
231049-1 Issued in NY
Practice address
1000 Silver Street
Connecticut Valley Hospital
Middletown, CT 06457-3940
Phone
(860) 262-5868
NPI assigned
Dec 11, 2006
Last updated
Apr 7, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 231049-1 NY Primary

Addresses

Primary practice location

1000 Silver Street
Connecticut Valley Hospital
Middletown, CT 06457-3940

Mailing address

1000 Silver Street
Connecticut Valley Hospital
Middletown, CT 06457-3940
Phone (860) 262-5868

Other identifiers 1

IdentifierTypeStateIssuer
231049-1OtherNYMEDICAL LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090827000194 CT Practitioner - Psychiatry 0840215646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York Downstate Medical Center, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

1000 Silver St
Middletown, CT 06457-3940
Phone (860) 262-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
231049-1NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Jul 18, 2009 Accepting new patients
State of Connecticut CurrentSince Jul 18, 2009 Accepting new patients

Locations

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239062400000",
    "number": "1902966997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SILVER STREET",
            "address_2": "CONNECTICUT VALLEY HOSPITAL",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573940",
            "telephone_number": "860-262-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SILVER STREET",
            "address_2": "CONNECTICUT VALLEY HOSPITAL",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573940",
            "telephone_number": "860-262-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHEUBLIN",
        "first_name": "MARC",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2009-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "231049-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "231049-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.