NPIMap

Organization Active NPI

Middlesex Hospital

Doing business as Middlesex Hospital dba Middlesex Hospital Physician Services

  • Family Nurse Practitioner
  • Middletown, CT
National Provider Identifier
1972563138
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MIDDLESEX HOSPITAL
Doing business as
Middlesex Hospital dba Middlesex Hospital Physician Services
Practice address
80 S Main St
Middletown, CT 06457-3648
Phone
(860) 358-6394
Fax
(860) 358-6094
NPI assigned
Mar 23, 2006
Last updated
Apr 3, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
MIDDLESEX HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Authorized official

Name
Vincent G. Capece Jr.
Title
Ceo
Phone
(860) 358-6140

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X CT
Family Medicine Physician 207Q00000X CT
Adult Medicine Physician 207QA0505X 53426 CT
Internal Medicine Physician 207R00000X CT
Critical Care Medicine (Internal Medicine) Physician 207RC0200X CT
Infectious Disease Physician 207RI0200X CT
Pulmonary Disease Physician 207RP1001X CT
Neurology Physician 2084N0400X CT
Hospitalist Physician 208M00000X CT
Medical Physician Assistant 363AM0700X CT
Nurse Practitioner 363L00000X 001743 CT
Acute Care Nurse Practitioner 363LA2100X CT
Adult Health Nurse Practitioner 363LA2200X CT
Family Nurse Practitioner 363LF0000X CT Primary

Addresses

Primary practice location

80 S Main St
Middletown, CT 06457-3648

Mailing address

80 S Main St
Middletown, CT 06457-3648
Phone (860) 358-6394

Other identifiers 2

IdentifierTypeStateIssuer
004121125MedicaidCT
CK1085OtherCTRR MEDICARE

Other names 1

  • Middlesex Hospital dba Middlesex Hospital Physician Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031216000592 CT Part B Supplier - Clinic/Group Practice 5092611731 Receives reassigned benefits from 187 practitioners
Practice locations: Middletown, CT; Westbrook, CT; Old Saybrook, CT

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Middlesex Hospital Dba Middlesex Hospital Physician Services

Locations

252 Westbrook Rd
Essex, CT 06426
Phone (860) 358-2700

80 S Main St
Ste 101
Middletown, CT 06457
Phone (860) 358-5970

80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878

80 S Main St
Ste 304
Middletown, CT 06457
Phone (860) 358-4615

90 S Main St
Ste 202
Middletown, CT 06457
Phone (860) 358-8680

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Middlesex Health Care at HomeMiddletown, CT, CCN 077086A Home health agency Operational/Managerial Control Feb 9, 1997

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 252

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 252

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554249600000",
    "number": "1972563138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573648",
            "telephone_number": "860-358-6394",
            "fax_number": "860-358-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573648",
            "telephone_number": "860-358-6394",
            "fax_number": "860-358-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLESEX HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDDLESEX HOSPITAL",
        "enumeration_date": "2006-03-23",
        "last_updated": "2019-04-03",
        "status": "A",
        "authorized_official_last_name": "CAPECE",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "860-358-6140",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CT",
            "license": "53426",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "001743",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004121125",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CK1085",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middlesex Hospital dba Middlesex Hospital Physician Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Middlesex Hospital dba Middlesex Hospital Physician Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.