Individual provider Active NPI

Frederick Pope, MD

  • Internal Medicine Physician
  • Wethersfield, CT
National Provider Identifier
1912984618
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
017871 Issued in CT
Practice address
30 Jordan LN
Wethersfield, CT 06109-1278
Phone
(860) 263-0263
Fax
(860) 263-0267
NPI assigned
Dec 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 017871 CT Primary

Addresses

Primary practice location

30 Jordan LN
Wethersfield, CT 06109-1278

Mailing address

30 Jordan LN
Wethersfield, CT 06109-1278
Phone (860) 263-0263

Other identifiers 3

IdentifierTypeStateIssuer
017871OtherCTMEDICAL LICENSE
001178714MedicaidCT
010017871CT02OtherBCBC CT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fpope16900@direct.stfranciscare.org Direct

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
I20091203000486 CT Practitioner - Internal Medicine 7315036175 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017871CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare, PC Internal Medicine CurrentSince Jan 1, 1998 Accepting new patients
Prime Healthcare (Sleep Lab) CurrentSince Jan 1, 1998 Accepting new patients

Locations

30 Jordan Ln
Wethersfield, CT 06109
Phone (860) 263-0253

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.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1912984618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 JORDAN LN",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091278",
            "telephone_number": "860-263-0263",
            "fax_number": "860-263-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 JORDAN LN",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091278",
            "telephone_number": "860-263-0263",
            "fax_number": "860-263-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPE",
        "first_name": "FREDERICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2023-03-07",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "017871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "017871",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001178714",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBC CT",
            "identifier": "010017871CT02",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fpope16900@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Prime Healthcare Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "30 Jordan Ln",
            "city": "Wethersfield",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061091278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

Verify at the official NPI Registry.