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MANCHESTER PEDIATRIC ASSOCIATES LLC
NPI 1053612911
Pediatrics in South Windsor, CT

Active since November 09, 2010CLIA Certified · 2 labs
2701 TAMARACK AVE, SOUTH WINDSOR, CT 06074(860) 647-8282(860) 647-8399 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Manchester Pediatric Associates Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MANCHESTER PEDIATRIC ASSOCIATES LLC (NPI 1053612911) is a healthcare organization registered as a pediatrics in South Windsor, Connecticut and active in the NPI registry since November 2010. The organization holds 2 active CLIA laboratory certificates, maintains 4 additional practice locations, and lists Swathanthra Kumar Melekote, Owner, as its authorized official.

NPPES Registry Identity

NPI1053612911
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameMANCHESTER PEDIATRIC ASSOCIATES LLC
Location Address2701 TAMARACK AVESouth Windsor, CT 06074-5561
Mailing Address2701 Tamarack AveSouth Windsor, CT 06074-5561 · (860) 647-8282 · Fax (860) 647-8399
Phone(860) 647-8282
Fax(860) 647-8399
Organization SubpartNo
Authorized OfficialSwathanthra Kumar MelekoteOwner · (860) 647-8282
Enumeration DateNovember 9, 2010
Last NPPES UpdateMarch 17, 2018
✔ NPI 1053612911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CT · 043564
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2701 TAMARACK AVE, South Windsor, CT 06074
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Secondary Practice Locations 4

Location 1150 Hazard Ave Bldg BEnfield, CT 06082-4587 · Phone (860) 749-3661
Location 289 West Rd Ste 1Ellington, CT 06029-3718 · Phone (860) 647-8282 ext. 108 · Fax (860) 647-8399
Location 352 Peck Rd Ste DTorrington, CT 06790-6107 · Phone (860) 482-1170 · Fax (860) 647-8399
Location 4130 Hartford RdManchester, CT 06040-5921 · Phone (860) 647-8282 · Fax (860) 647-8399

Other Identifiers 1

Medicaid1629061965CT

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D2166888

Manchester Pediatric Associates Dba Kids Station Pediatrics · South Windsor, CT
Active · expires May 28, 2027
CLIA Number07D2166888
Laboratory TypePhysician Office
Certificate Effective DateMay 29, 2025
Certificate Expiration DateMay 28, 2027
Laboratory DirectorJohn H. Walker
Laboratory Phone(860) 647-8282
Laboratory LocationManchester Pediatric Associates Dba Kids Station Pediatrics2701 Tamarack Ave 1st Flr, South Windsor, CT 06074
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 07D1085308

Manchester Pediatric Associates · South Windsor, CT
Active · expires Apr 17, 2027
CLIA Number07D1085308
Laboratory TypePhysician Office
Certificate Effective DateApril 18, 2025
Certificate Expiration DateApril 17, 2027
Laboratory DirectorSwathanthra K. Melekote, MD
Laboratory Phone(860) 647-8282
Laboratory LocationManchester Pediatric Associates2701 Tamarack Ave, South Windsor, CT 06074
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NIKISHA BISTA HAMAL FNP-C
Nurse Practitioner (Family)
2701 TAMARACK AVE
SOUTH WINDSOR, CT 06074
Capitol Planning Region (860) 647-8282
MRS. LORI ANN BRYON PA C
Physician Assistant
2701 TAMARACK AVE
SOUTH WINDSOR, CT 06074
Capitol Planning Region (860) 647-8282
SREENIVAS DUTT GUNTURU M.D.
Pediatrics
2701 TAMARACK AVE
SOUTH WINDSOR, CT 06074
Capitol Planning Region (860) 647-8282
JOHN HENRY WALKER M.D.
Pediatrics
2701 TAMARACK AVE
SOUTH WINDSOR, CT 06074
Capitol Planning Region (860) 647-8282
DR. FREDERIC JACOB BERNSTEIN D.O.
Pediatrics
2701 TAMARACK AVE
SOUTH WINDSOR, CT 06074
Capitol Planning Region (860) 647-8282
DR. GAYETHRI NARAYANSWAMY M.D.
Family Medicine
2701 TAMARACK AVE
SOUTH WINDSOR, CT 06074
Capitol Planning Region (860) 375-5141
CONNECTICUT MIND INSTITUTE LLC
Psychiatry & Neurology (Child & Adolescent Psychiatry)
2701 TAMARACK AVE
SOUTH WINDSOR, CT 06074
Capitol Planning Region (860) 337-7818
ASYA TSARKOVA LMSW
Social Worker (Clinical)
2701 TAMARACK AVE
SOUTH WINDSOR, CT 06074
Capitol Planning Region (860) 215-4389

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Manchester Pediatric Associates LLC's NPI number?

The NPI number for Manchester Pediatric Associates LLC is 1053612911. It was assigned to this organization in the NPPES registry on November 9, 2010.

Where is Manchester Pediatric Associates LLC located?

Manchester Pediatric Associates LLC is located at 2701 Tamarack Ave, South Windsor, CT 06074. The listed phone number is (860) 647-8282.

What is Manchester Pediatric Associates LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Manchester Pediatric Associates LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Manchester Pediatric Associates LLC was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.