Nicole Spataro
Physician Assistant (Surgical)

Address: 71 Haynes St, Suite 1209, Manchester, CT 06040-4131
Phone: 8605336595

Nicole Spataro (NPI# 1215358973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1215358973
Entity Type Individual
Full Name Nicole Spataro
Gender Female
Practice Address 71 Haynes St
Suite 1209
Manchester
CT 06040-4131
Practice Telephone 8605336595
Mailing Address 71 Haynes St.
Suite 1209
Manchester
CT 06040
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2013-12-26
Last Update Date 2013-12-26

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363AS0400X Physician Assistant · Surgical Physician Assistants & Advanced Practice Nursing Providers 23.003034 CT

Physician Overview

NPI 1215358973
PAC ID by PECOS 9032334735
Professional Enrollment ID I20140715000053
Full Name Nicole M Spataro
Organization Legal Name PROSPECT CT MEDICAL FOUNDATION, INC.
Phone Number 8606497557
Gender F
Graduation Year 2013
Primary Specialty PHYSICIAN ASSISTANT
Group Practice PAC ID 7416244496
Number of Group Practice Members 217
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
070027 MANCHESTER MEMORIAL HOSPITAL
070012 ROCKVILLE GENERAL HOSPITAL

Office Location

Street Address 71 HAYNES ST
SUITE 1209
City MANCHESTER
State CT
Zip Code 06040-4131

Providers in the same location

NPI Name Taxonomy Address Enumeration
1518438530 Kevin William Abbate Nurse Anesthetist, Certified Registered 71 Haynes St, Manchester, CT 06040-4131 2018-12-17
1962988592 Thomas Russell Rozea Physician Assistant 71 Haynes St, Manchester, CT 06040-4131 2018-07-17
1396232476 Erin Elizabeth Osborn Student in an Organized Health Care Education/Training Program 71 Haynes St, Manchester, CT 06040-4188 2018-04-15
1568959740 Arisha Marie Abana Carreon Student in an Organized Health Care Education/Training Program 71 Haynes St, Manchester, CT 06040-4131 2018-04-13
1093210114 Jonathan Taylor Grossman Student in an Organized Health Care Education/Training Program 71 Haynes St, Manchester, CT 06040-4131 2018-03-29
1710480892 Jackson Chen Student in an Organized Health Care Education/Training Program 71 Haynes St, Manchester, CT 06040-4131 2018-03-14
1528567807 Rochelle Rivera Social Worker 71 Haynes St, Manchester, CT 06040 2018-02-01
1740794106 Shea Kozak Physician Assistant 71 Haynes St, Manchester, CT 06040-4131 2017-11-21
1033638366 Danielle Kirei Physician Assistant 71 Haynes St, Manchester, CT 06040-4131 2017-09-19
1972022135 Colleen Booth Physician Assistant 71 Haynes St, Manchester, CT 06040-4131 2017-09-19
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1972072072 Connecticut Cvs Pharmacy LLC Durable Medical Equipment & Medical Supplies 1221 Main St, Manchester, CT 06040 2018-11-19
1538689534 Bernard Ashirifie Counselor 869 Main Street, Apt 3, Manchester, CT 06040 2017-06-21
1497275697 Justin David Chung Student in an Organized Health Care Education/Training Program 483 Middle Tpke W Ste 209, Manchester, CT 06040 2017-06-20
1114473436 Amanda Edgar Counselor 469 Center Street, Manchester, CT 06040 2016-08-28
1760831366 Samantha Micael Marriage & Family Therapist 200 West Center Street, Suite C-2-6, Manchester, CT 06040 2016-06-06
1962856179 Odelia Brew Nurse Practitioner 256 Hackmatack Street, Manchester, CT 06040 2016-04-14
1831566983 Gary Cesca Social Worker 45 North School St, Manchester Public Schools, Manchester, CT 06040 2015-08-25
1083098156 Stephanie Sturgis Optometrist 397b Broad Street, Manchester, CT 06040 2015-07-17
1396137709 Daniel Ernest Morgan Internal Medicine 29 Haynes St Ste D, Manchester, CT 06040 2015-02-21
1124417167 Mclean Wellness Group, LLC Psychologist 117 E. Center St., Manchester, CT 06040 2015-01-14
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1548743875 Sarah Ann Soifert Physician Assistant 100 Mcgregor St, Manchester, NH 03102-3770 2018-09-12
1215458740 Felicia F Mingrone Physician Assistant 71 Haynes St, Manchester, CT 06040-4131 2017-07-06
1770933541 Alyssa Olsen Physician Assistant 71 Haynes St, Manchester, CT 06040-4131 2016-06-13
1356716302 Mason Dunn-mcdonagh Physician Assistant 71 Haynes St, Manchester, CT 06040-4131 2015-12-02
1093195182 Pamela Frappier Physician Assistant 71 Haynes St, Manchester, CT 06040-4131 2015-06-03
1134511595 Nicole A. Wizeman Physician Assistant 71 Haynes St, Manchester, CT 06040-4131 2015-02-23
1053702845 Andrea Lynch Physician Assistant 71 Haynes St, Manchester, CT 06040-4131 2015-02-14
1639560626 Kayla Koza Physician Assistant 71 Haynes St, Manchester, CT 06040-4131 2015-02-11
1164812418 Michael P Cacciola Physician Assistant 185 Queen City Ave, Elliot Orthopaedic Surgery, Manchester, NH 03101-7121 2015-01-26
1003228479 Lauren Jean Welton Physician Assistant 100 Hitchcock Way, D-h Manchester, General Surgery, Manchester, NH 03104-4125 2014-05-20
Find all providers in MANCHESTER

Competitor

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City MANCHESTER
Zip Code 06040

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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