NPIMap

Organization Active NPI

Mdlive Medical Group de PA

  • Family Medicine Physician
  • Bloomfield, CT
National Provider Identifier
1992178115
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MDLIVE MEDICAL GROUP DE PA
Practice address
900 Cottage Grove Rd
Bloomfield, CT 06002-2920
Phone
(800) 400-6354
NPI assigned
Nov 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Authorized official

Name
Sue-Ann Adrians
Title
Government Programs PM
Phone
(945) 275-1345

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Sports Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0010X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

900 Cottage Grove Rd
Bloomfield, CT 06002-2920

Mailing address

PO Box 5006
Hartford, CT 06102-5006

Other practice location 1

4500 Forbes Blvd Ste 200
Lanham, MD 20706-6316
Phone (800) 400-6354

Other practice location 2

18 Campus Blvd Ste 100
Newtown Square, PA 19073-3240
Phone (800) 400-6354

Other practice location 3

310 E 96th St Ste 200
Indianapolis, IN 46240-0120
Phone (800) 400-6354

Other practice location 4

300 Bellevue Pkwy Ste 135
Wilmington, DE 19809-3704
Phone (800) 400-6354

Other practice location 5

90 Canal St Ste 4
Boston, MA 02114-2022
Phone (800) 400-6354

Other practice location 6

525 W Monroe St Ste 1650
Chicago, IL 60661-3647
Phone (800) 400-6354

Other practice location 7

1661 International Dr Ste 400
Memphis, TN 38120-1431
Phone (800) 400-6354

Other identifiers 1

IdentifierTypeStateIssuer
335824MedicaidAZ

Other names 1

  • MDLIVE MEDICAL GROUP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mdlive Medical Group de PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

300 Bellevue Pkwy
Ste 135
Wilmington, DE 19809

310 E 96th St
Ste 200
Indianapolis, IN 46240
Phone (317) 344-9490

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1992178115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5006",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 COTTAGE GROVE RD",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022920",
            "telephone_number": "800-400-6354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Forbes Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lanham",
            "state": "MD",
            "postal_code": "207066316",
            "country_code": "US",
            "telephone_number": "800-400-6354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18 Campus Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Newtown Square",
            "state": "PA",
            "postal_code": "190733240",
            "country_code": "US",
            "telephone_number": "800-400-6354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 E 96th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462400120",
            "country_code": "US",
            "telephone_number": "800-400-6354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Bellevue Pkwy Ste 135",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198093704",
            "country_code": "US",
            "telephone_number": "800-400-6354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "90 Canal St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142022",
            "country_code": "US",
            "telephone_number": "800-400-6354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 W Monroe St Ste 1650",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606613647",
            "country_code": "US",
            "telephone_number": "800-400-6354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1661 International Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381201431",
            "country_code": "US",
            "telephone_number": "800-400-6354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MDLIVE MEDICAL GROUP DE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "ADRIANS",
        "authorized_official_first_name": "SUE-ANN",
        "authorized_official_title_or_position": "GOVERNMENT PROGRAMS PM",
        "authorized_official_telephone_number": "945-275-1345"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335824",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MDLIVE MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.