Individual provider Active NPI

Nicole Monahan, APRN

  • Adult Health Nurse Practitioner
  • Willimantic, CT
National Provider Identifier
1992161558
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
6401 Issued in CT
Practice address
150 Mansfield Ave
Willimantic, CT 06226-2026
Phone
(860) 423-3299
Fax
(860) 423-8739
NPI assigned
Jan 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 6401 CT Primary

Addresses

Primary practice location

150 Mansfield Ave
Willimantic, CT 06226-2026

Mailing address

150 Mansfield Ave
Willimantic, CT 06226-2026
Phone (860) 423-3299

Other identifiers 1

IdentifierTypeStateIssuer
6401OtherCTAPRN LICENSE

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160229000076 CT Practitioner - Nurse Practitioner 8123323219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.99 of 100Reported as group
Quality
89.16
Promoting interoperability
100
Improvement activities
40
Cost
78.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6401CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Gi PLLC CurrentSince Sep 1, 2022 Accepting new patients
Litchfield County Gastroenterology Associates, LLC Past Accepting new patients

Locations

85 Seymour St
Ste 1000
Hartford, CT 06106
Phone (860) 246-2571

30 Waterchase Dr
Rocky Hill, CT 06067
Phone (860) 257-4131

Organizations & group practices 2

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": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1992161558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262026",
            "telephone_number": "860-423-3299",
            "fax_number": "860-423-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262026",
            "telephone_number": "860-423-3299",
            "fax_number": "860-423-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONAHAN",
        "first_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "6401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "6401",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.