Heather Lynn Champagne, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001750 Issued in CT

Practice address

100 Grand St
New Britain, CT 06052-2016

Phone

(860) 224-5691

Fax

(860) 224-5795

NPI assigned

Jan 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hchampagne27717@connecticutchildrens.direct-ci.com

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.

• Connecticut Children'S Specialty Group, Inc.

  • Pediatrics Physician
  • Hartford, CT
  • NPI 1669448882
  Medicare reassignment NPD

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1962473926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GRAND ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060522016",
            "telephone_number": "860-224-5691",
            "fax_number": "860-224-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRAND ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060522016",
            "telephone_number": "860-224-5691",
            "fax_number": "860-224-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPAGNE",
        "first_name": "HEATHER",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "001750",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hchampagne27717@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "100 Grand St",
            "city": "New Britain",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060522016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Central Connecticut Pathology Consultants, P.C.
• Central Connecticut Procedure Center, LLC
• Central Connecticut Radiation Oncology PC
• Paul J Ceplenski, M.D.
• Angela Chafee, PSY.D.
• Adrian Chan, M.D.
• Aviral Chandra
• Krystle Charran-Sankar, LMFT
• Charter Oak Dental Center LL LLC
• Jennifer Lynn Chasse

• Medical Physician Assistant in New Britain, CT
• Providers in New Britain, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.