Prime Healthcare, Pc - Medicare Primary Care in Wethersfield, CT

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Prime Healthcare, Pc is a medicare enrolled primary clinic (Internal Medicine) in Wethersfield, Connecticut. The current practice location for Prime Healthcare, Pc is 30 Jordan Ln, Wethersfield, Connecticut. For appointments, you can reach them via phone at (860) 263-0253. The mailing address for Prime Healthcare, Pc is 30 Jordan Ln, Wethersfield, Connecticut and phone number is (860) 263-0253.

Prime Healthcare, Pc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1184819302. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (860) 263-0253.

Contact Information

Prime Healthcare, Pc
30 Jordan Ln
Wethersfield
CT 06109-1278
(860) 263-0253
(860) 263-0262

Map and Direction


Primary Care Clinic Profile

Full NamePrime Healthcare, Pc
SpecialityInternal Medicine
Location30 Jordan Ln, Wethersfield, Connecticut
Authorized Official Name and PositionSusan Albano (CEO)
Authorized Official Contact8602630253
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Prime Healthcare, Pc
30 Jordan Ln
Wethersfield
CT 06109-1278

Ph: (860) 263-0253		Prime Healthcare, Pc
30 Jordan Ln
Wethersfield
CT 06109-1278

Ph: (860) 263-0253

NPI Details:

NPI Number1184819302
Provider Enumeration Date09/11/2007
Last Update Date08/03/2015

Medicare PECOS Information:

Medicare PECOS PAC ID6709787930
Medicare Enrollment IDO20040121000411

Medical Identifiers

Medical identifiers for Prime Healthcare, Pc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1184819302NPI-NPPES
004201480MedicaidCT
008058707MedicaidCT
004185147MedicaidCT

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (* (Not Available))Primary
207RC0200XInternal Medicine - Critical Care Medicine (* (Not Available))Secondary
207RE0101XInternal Medicine - Endocrinology, Diabetes & Metabolism (* (Not Available))Secondary
207RG0100XInternal Medicine - Gastroenterology (* (Not Available))Secondary
207RG0300XInternal Medicine - Geriatric Medicine (* (Not Available))Secondary
207RP1001XInternal Medicine - Pulmonary Disease (* (Not Available))Secondary
208000000XPediatrics 54316 (Connecticut)Secondary
208M00000XHospitalist (* (Not Available))Secondary
363A00000XPhysician Assistant (* (Not Available))Secondary
363L00000XNurse Practitioner (* (Not Available))Secondary
363LA2200XNurse Practitioner - Adult Health (* (Not Available))Secondary
363LF0000XNurse Practitioner - Family (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Prime Healthcare, Pc acts as a billing entity for following providers:
Provider NameFielding Johnson
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1346336237
PECOS PAC ID: 0345140927
Enrollment ID: I20040114000083
Provider NameCarol A Petruff
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1083691794
PECOS PAC ID: 0749181964
Enrollment ID: I20040120000244
Provider NameE Spencer Joslin
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1760450886
PECOS PAC ID: 8729980115
Enrollment ID: I20040126000311
Provider NameHerbert Dimeola
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1528024015
PECOS PAC ID: 6608855192
Enrollment ID: I20040802001437
Provider NameAlberto Juan Rodriguez
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1316967037
PECOS PAC ID: 9830164623
Enrollment ID: I20040826000578
Provider NameJorge Luis Diez
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1316940463
PECOS PAC ID: 5799776902
Enrollment ID: I20040827000183
Provider NameGerald A Valletta
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1417991688
PECOS PAC ID: 2466427620
Enrollment ID: I20040831000882
Provider NameKatherine Thomsen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659344174
PECOS PAC ID: 4486621539
Enrollment ID: I20040916000815
Provider NameMichelle C Steele
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578604666
PECOS PAC ID: 7911976675
Enrollment ID: I20040929000451
Provider NameCristina Ortega
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1376549477
PECOS PAC ID: 3173592771
Enrollment ID: I20040930000303
Provider NameRolf W Knoll
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1881696193
PECOS PAC ID: 3375530660
Enrollment ID: I20050502000478
Provider NameRebekah Pointek
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144299694
PECOS PAC ID: 2860429248
Enrollment ID: I20050719000153
Provider NameTapas Bandyopadhyay
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1861491839
PECOS PAC ID: 0143251041
Enrollment ID: I20050830000451
Provider NamePaula C Rocha
Provider TypePractitioner - Certified Clinical Nurse Specialist (cns)
Provider IdentifiersNPI Number: 1659457638
PECOS PAC ID: 0648202382
Enrollment ID: I20050902000201
Provider NameLeeanne E Shaw Quinn
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487727228
PECOS PAC ID: 3779504436
Enrollment ID: I20051209000600
Provider NameElizabeth M B Visone
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114924172
PECOS PAC ID: 4880602903
Enrollment ID: I20060331000366
Provider NameKeryn Rausch
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316036940
PECOS PAC ID: 2668470717
Enrollment ID: I20061128000150
Provider NameWayne C Chen
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1679640841
PECOS PAC ID: 4688777469
Enrollment ID: I20070315000341
Provider NameAnthony M Roselli
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1518970425
PECOS PAC ID: 6608975578
Enrollment ID: I20070620000035
Provider NameAdarsh A Jha
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1710188685
PECOS PAC ID: 7315031440
Enrollment ID: I20070920000508
Provider NameShauna A Rago
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457544728
PECOS PAC ID: 8123114238
Enrollment ID: I20071022000212
Provider NameGuy T Trono
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1487670071
PECOS PAC ID: 7113005596
Enrollment ID: I20080514000849
Provider NameDeborah A Ellison
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356508691
PECOS PAC ID: 4183797186
Enrollment ID: I20080724000385
Provider NameArvind Suri
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1780856252
PECOS PAC ID: 3072671882
Enrollment ID: I20081023000354
Provider NameDavid P Grise
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1982681599
PECOS PAC ID: 4880783646
Enrollment ID: I20081028000188
Provider NameGolam R Gazi
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1427076330
PECOS PAC ID: 1153489745
Enrollment ID: I20081029000459
Provider NameJocelyn S Libros
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619128956
PECOS PAC ID: 1153488838
Enrollment ID: I20090325000017
Provider NameJanice Whedon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942460159
PECOS PAC ID: 9931257805
Enrollment ID: I20090504000005
Provider NameMarie E Burton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568619302
PECOS PAC ID: 0143370874
Enrollment ID: I20090618000049
Provider NameJacob Zamstein
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1619969094
PECOS PAC ID: 4284772898
Enrollment ID: I20091118000532
Provider NameWilliam R Preskenis
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1104803808
PECOS PAC ID: 9133218993
Enrollment ID: I20091201000661
Provider NameRonald P Josephson
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1639156250
PECOS PAC ID: 0941349161
Enrollment ID: I20091201000670
Provider NameM Nathan Lassman
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1629040357
PECOS PAC ID: 1052400819
Enrollment ID: I20091202000044
Provider NameRonald E Kimmel
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1649257338
PECOS PAC ID: 4789773540
Enrollment ID: I20091202000198
Provider NameNanette H Alexander
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568449262
PECOS PAC ID: 2062551120
Enrollment ID: I20091202000466
Provider NameJennifer L Karanian
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1295712826
PECOS PAC ID: 2365581436
Enrollment ID: I20091202000553
Provider NameJohn W Rodgers
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1588641112
PECOS PAC ID: 2062314131
Enrollment ID: I20091202000589
Provider NamePhilip J Karanian
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1437136132
PECOS PAC ID: 5799874558
Enrollment ID: I20091203000370
Provider NameFrederick J Pope
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1912984618
PECOS PAC ID: 7315036175
Enrollment ID: I20091203000486
Provider NameSybil L Sandoval
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1407833106
PECOS PAC ID: 5890834832
Enrollment ID: I20091203000515
Provider NameBrian M Vanlinda
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1578540100
PECOS PAC ID: 1759283823
Enrollment ID: I20091207000562
Provider NameAlan Soroka
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1720065428
PECOS PAC ID: 4486743242
Enrollment ID: I20091209000330
Provider NameGeorge M Donahue
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1710964325
PECOS PAC ID: 1254420011
Enrollment ID: I20091209000473
Provider NameWayne C Paulekas
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1730166422
PECOS PAC ID: 7416859582
Enrollment ID: I20091230000598
Provider NameGregory C Walsh
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1063496883
PECOS PAC ID: 5294776597
Enrollment ID: I20100108000405
Provider NameMatthew Colliton
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1609853126
PECOS PAC ID: 1456392752
Enrollment ID: I20100108000438
Provider NameAnthony Zaldonis
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1144207853
PECOS PAC ID: 4688763444
Enrollment ID: I20100109000214
Provider NameMaria C Renna
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1164750030
PECOS PAC ID: 5395873178
Enrollment ID: I20100514000877
Provider NameRonald Buckman
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1871561092
PECOS PAC ID: 4385709179
Enrollment ID: I20100908000165
Provider NameSandra C Palmer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316931249
PECOS PAC ID: 7911049838
Enrollment ID: I20110203001031
Provider NameHollie S Smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245531771
PECOS PAC ID: 7416139050
Enrollment ID: I20110303000399
Provider NameErica H Lambert
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1285803528
PECOS PAC ID: 5092888479
Enrollment ID: I20110829000471
Provider NamePolina M Melamud
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821376740
PECOS PAC ID: 0042480188
Enrollment ID: I20110830000038
Provider NamePeter Bosco
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1992725683
PECOS PAC ID: 2668550047
Enrollment ID: I20110930000466
Provider NameJanine M Wilcox
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609841147
PECOS PAC ID: 0143487900
Enrollment ID: I20120206000707
Provider NameSuzette M Orzechowski
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962779058
PECOS PAC ID: 8022276070
Enrollment ID: I20120221001097
Provider NameJennifer H Ross
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1952666174
PECOS PAC ID: 2163678954
Enrollment ID: I20120810000036
Provider NameSerita Smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417203142
PECOS PAC ID: 2062661085
Enrollment ID: I20121009000005
Provider NameJoan F Schwartz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679822399
PECOS PAC ID: 7719122357
Enrollment ID: I20130402000037
Provider NameAmber Christel Berry
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821426487
PECOS PAC ID: 6406087204
Enrollment ID: I20140319002388
Provider NameLydia R Roldan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548280175
PECOS PAC ID: 3678706801
Enrollment ID: I20140423002374
Provider NameJason T Strickland
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568552826
PECOS PAC ID: 8224251079
Enrollment ID: I20140522002169
Provider NameKathi J Karp
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265855068
PECOS PAC ID: 0345467924
Enrollment ID: I20140805000967
Provider NameSwapnil D Munsaf
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1891811188
PECOS PAC ID: 2264688068
Enrollment ID: I20140820000721
Provider NameJohn Kouch
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1801024476
PECOS PAC ID: 5294955787
Enrollment ID: I20141006000255
Provider NameLynne E Benjamin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134528946
PECOS PAC ID: 7012139645
Enrollment ID: I20141114000028
Provider NameSandra A Criscuolo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487052189
PECOS PAC ID: 3577887785
Enrollment ID: I20150116001637
Provider NameCatherine Louise Francis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629462940
PECOS PAC ID: 0345560009
Enrollment ID: I20150520000527
Provider NameDmitry A Albin
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1295906345
PECOS PAC ID: 8729148010
Enrollment ID: I20150602000512
Provider NameLoreen M Williams
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285003988
PECOS PAC ID: 5193025278
Enrollment ID: I20151120001785
Provider NameRoshelle Tappin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821454158
PECOS PAC ID: 2961701602
Enrollment ID: I20160429001483
Provider NameGerard J Pregenzer
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1457647281
PECOS PAC ID: 0345531976
Enrollment ID: I20160629000037
Provider NameThomas J Corredine
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1417214214
PECOS PAC ID: 4789986399
Enrollment ID: I20160802000132
Provider NameKara S Nelsen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902350382
PECOS PAC ID: 9739467978
Enrollment ID: I20161024000771
Provider NameAida Becker
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1932204948
PECOS PAC ID: 9537150594
Enrollment ID: I20170117000156
Provider NameJennifer Jerome
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134661531
PECOS PAC ID: 8729361845
Enrollment ID: I20170215000203
Provider NameSarah E Monahan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811437049
PECOS PAC ID: 7719262807
Enrollment ID: I20170403001800
Provider NameDonna M Witkins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649795055
PECOS PAC ID: 6507130010
Enrollment ID: I20170922000025
Provider NameMarcy A Calsetta
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1184140394
PECOS PAC ID: 5496021735
Enrollment ID: I20171101000387
Provider NameMeghan Philips
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538687884
PECOS PAC ID: 6406114313
Enrollment ID: I20171226001569
Provider NameBrian B Gomes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669972444
PECOS PAC ID: 2466715560
Enrollment ID: I20180423002689
Provider NameSarah Yiznitsky
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285164111
PECOS PAC ID: 6901161413
Enrollment ID: I20180605001172
Provider NameMelanie Elizabeth Tidmarsh
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346729928
PECOS PAC ID: 5496006074
Enrollment ID: I20180920001305
Provider NameJennifer Lewis Pyrro
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871075671
PECOS PAC ID: 0840541421
Enrollment ID: I20180920001333
Provider NameAblan Berko
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053749812
PECOS PAC ID: 9739317363
Enrollment ID: I20190114002298
Provider NameJude Martine Hall
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013574425
PECOS PAC ID: 8527392273
Enrollment ID: I20190628001889
Provider NameEvelyn Boateng
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588154363
PECOS PAC ID: 7416281910
Enrollment ID: I20190702002327
Provider NameRadhika Naga Ayyagari
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1598109753
PECOS PAC ID: 9335431386
Enrollment ID: I20190703000610
Provider NameLisa Anne Knoll
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740766500
PECOS PAC ID: 0446585988
Enrollment ID: I20190705000691
Provider NameSohaib Jamil
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1417215161
PECOS PAC ID: 6709111453
Enrollment ID: I20190717002236
Provider NameKawarjeet Singh
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1780098541
PECOS PAC ID: 1759652613
Enrollment ID: I20190918000983
Provider NameMichele Bowdy
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1629215066
PECOS PAC ID: 5496801532
Enrollment ID: I20191111002512
Provider NamePatrene Rhoden
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750924429
PECOS PAC ID: 7214369909
Enrollment ID: I20191119000517
Provider NameSusan Elizabeth Campbell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891337952
PECOS PAC ID: 4183057383
Enrollment ID: I20191202001126
Provider NameMeagan Platt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871135962
PECOS PAC ID: 3476987843
Enrollment ID: I20191218002684
Provider NameBrooke M P Chaves
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003425745
PECOS PAC ID: 6002228855
Enrollment ID: I20201218001876
Provider NameKristina Maria Deconti
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003491036
PECOS PAC ID: 9739596057
Enrollment ID: I20210401001078
Provider NameJonathan B Lis
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1528558939
PECOS PAC ID: 0244585859
Enrollment ID: I20210506000799
Provider NameShanta Tiffany Shepherd
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1174986756
PECOS PAC ID: 1254626518
Enrollment ID: I20210809003532
Provider NameRoslyn Clarissa Forde-tucker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417620600
PECOS PAC ID: 3678979903
Enrollment ID: I20210910002100
Provider NameJennifer Elizabeth Baranowski
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336813393
PECOS PAC ID: 1052717162
Enrollment ID: I20210914003174
Provider NameGarrett Whittaker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174149462
PECOS PAC ID: 3274922125
Enrollment ID: I20211115000805
Provider NameRuby May Morant
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699431916
PECOS PAC ID: 1153714829
Enrollment ID: I20220202001581
Provider NameMichael E Goltzman
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1326570722
PECOS PAC ID: 8123390457
Enrollment ID: I20220531001717
Provider NameKayla Kriscenski
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609321801
PECOS PAC ID: 5597043158
Enrollment ID: I20220606001435
Provider NameSaumya Shah
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1770046369
PECOS PAC ID: 9739560871
Enrollment ID: I20220720001670
Provider NameLindsey Petrangelo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023614286
PECOS PAC ID: 6002221504
Enrollment ID: I20220726000829
Provider NameElayna Joy Lindblom
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821607672
PECOS PAC ID: 8921480369
Enrollment ID: I20220802002977
Provider NameSamuel Werner
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1942735659
PECOS PAC ID: 9931586765
Enrollment ID: I20220802003656
Provider NameJasveen Batra
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1497218986
PECOS PAC ID: 6800129719
Enrollment ID: I20220806000257
Provider NameLaurel J Robertson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144948001
PECOS PAC ID: 5597141309
Enrollment ID: I20221003000432
Provider NameAmy Lynn Lombardo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144937871
PECOS PAC ID: 3375901978
Enrollment ID: I20230614000156
Provider NameAaron J Turnquist
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1649776345
PECOS PAC ID: 6901154665
Enrollment ID: I20230821003272
Provider NameKristen Baer Delaney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1922786581
PECOS PAC ID: 0244694644
Enrollment ID: I20230919001855
Provider NameMonique Marie Brunelle
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1770368532
PECOS PAC ID: 3274987607
Enrollment ID: I20231003003117
Provider NameErin Kathleen Bamback
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528834983
PECOS PAC ID: 2365895950
Enrollment ID: I20240131000579

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Practice Location: 30 Jordan Ln, Wethersfield, CT 06109
Phone: 860-263-0263    Fax: 860-263-0267

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.