NPIMap

Organization Active NPI

Northeast Emergency Medicine Specialists, LLC

  • Emergency Medicine Physician
  • Willimantic, CT
National Provider Identifier
1982889598
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
NORTHEAST EMERGENCY MEDICINE SPECIALISTS, LLC
Practice address
112 Mansfield Ave
Willimantic, CT 06226-2045
Phone
(800) 261-0048
NPI assigned
Jan 2, 2008
Last updated
Nov 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

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

Authorized official

Name
Eugene Winchester, MDNPI 1104870294
Title
Manager
Phone
(800) 261-0048

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

112 Mansfield Ave
Willimantic, CT 06226-2045

Mailing address

6896 W Snowville Rd
Brecksville, OH 44141-3214

Other identifiers 1

IdentifierTypeStateIssuer
500HBE466CT01OtherCTANTHEM BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080516000028 CT Part B Supplier - Clinic/Group Practice 8729157797 Receives reassigned benefits from 156 practitioners
Practice locations: Manchester, CT; Southington, CT; Stafford Springs, CT; Vernon, CT; Waterbury, CT; Willimantic, CT

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 189

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 189

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257465600000",
    "number": "1982889598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6896 W SNOWVILLE RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441413214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262045",
            "telephone_number": "800-261-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST EMERGENCY MEDICINE SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2009-11-06",
        "status": "A",
        "authorized_official_last_name": "WINCHESTER",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "800-261-0048",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "500HBE466CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.