Individual provider Active NPI

Donna Tanganelli

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1962614677
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007102 Issued in CT
Practice address
228 Meadow St
Waterbury, CT 06702-1807
Phone
(203) 597-0643
Fax
(203) 597-0834
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 007102 CT Primary

Addresses

Primary practice location

228 Meadow St
Waterbury, CT 06702-1807

Mailing address

38 Old Ridgebury Rd
Danbury, CT 06810-5128
Phone (203) 792-4515

Other identifiers 1

IdentifierTypeStateIssuer
008017939MedicaidCT

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091102000087 CT Practitioner - Clinical Social Worker 8527105030 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007102CTMDClinical Social Worker
7102CTMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Waterbury, Inc. CurrentSince Oct 1, 2016 Accepting new patients
State of Connecticut CurrentSince Mar 4, 2012 Accepting new patients
State of Connecticut CurrentSince Mar 4, 2012 Accepting new patients
Waterbury Hospital Past Accepting new patients

Locations

78 Triangle St
Bldg 14
Danbury, CT 06810
Phone (203) 448-3200

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

55 W Main St
Ste 410
Waterbury, CT 06702
Phone (203) 805-6408

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

95 Thomaston Ave
Waterbury, CT 06702
Phone (203) 805-5300

Organizations & group practices 4

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1962614677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 OLD RIDGEBURY RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105128",
            "telephone_number": "203-792-4515",
            "fax_number": "203-748-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 MEADOW ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021807",
            "telephone_number": "203-597-0643",
            "fax_number": "203-597-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGANELLI",
        "first_name": "DONNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008017939",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.