Marie Helene Pouliot, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

038992 Issued in CT

Practice address

1062 Barnes Road
Suite 102
Wallingford, CT 06492

Phone

(203) 294-6328

Fax

(203) 294-6346

NPI assigned

Oct 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 2

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mariehelene.pouliot.npi1982780227.phpct@direct.optumcare.masshiway.net

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.

• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  Pediatrics

  Medicare reassignment NPD
• Long Wharf Pediatrics & Adolescent Medicine LLC

  • Pediatrics Physician
  • New Haven, CT
  • NPI 1679605471
  NPD (past)
• Luis Alonso MD PC

  dba Pediatric & Adolescent Medicine

  • Pediatric Adolescent Medicine Physician
  • Wallingford, CT
  • NPI 1629138748

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1982780227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1062 BARNES ROAD",
            "address_2": "SUITE 102",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-294-6328",
            "fax_number": "203-294-6346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1062 BARNES ROAD",
            "address_2": "SUITE 102",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-294-6328",
            "fax_number": "203-294-6346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULIOT",
        "first_name": "MARIE HELENE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-30",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "038992",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CT",
            "license": "038992",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001389924",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2664394",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "739460",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2822247",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2V5651",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi Poarch, PA-C
• Charleen W Poglitsch, RN
• Chloe Poloukhine, APRN
• Karen Ann Ponzio, RPT
• Brittany Post
• Mark Powers, PA
• Richard Henry Powers, D.C.
• Kevin Pratt, PT
• Jeffrey T Pravda, M.D.
• Precision Chiropractic Center LLC

• Pediatrics Physician in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Pediatrics Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.