FAMILY PRACTICE GROUP EAST HAMPTON
NPI 1114062114
Family Medicine in East Hampton, CT

NPI Status: Active since February 20, 2007

Contact Information

42 E HIGH ST
EAST HAMPTON, CT
ZIP 06424
Phone: (860) 344-6394
Fax: (860) 344-6748

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  • Organization
  • Family Medicine
  • CLIA Number: 07D0720274
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-22-2025

About FAMILY PRACTICE GROUP EAST HAMPTON

This page provides the complete NPI Profile along with additional information for Family Practice Group East Hampton, a primary care provider established in East Hampton, Connecticut operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1114062114 assigned on February 2007. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. Family Practice Group East Hampton operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Family Practice Group East Hampton. The authorized official of this NPI record is Marisa Pellerin (Credentialing/enrollment)

NPI
1114062114
Provider Legal Name
MIDDLESEX HOSPITAL DBA FAMILY PRACTICE GROUP EAST HAMPTON
Other Organization Name
FAMILY PRACTICE GROUP EAST HAMPTON
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
42 E HIGH ST EAST HAMPTON, CT 06424
Location Phone
(860) 344-6394
Location Fax
(860) 344-6748
Mailing Address
90 S MAIN ST MIDDLETOWN, CT 06457
Mailing Phone
(860) 358-6394
Mailing Fax
(860) 344-6748
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
02-20-2007
Last Update Date
03-06-2019
Code Navigator

A primary care provider (PCP) like Family Practice Group East Hampton sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License State
CT
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207QG0300XAllopathic & Osteopathic Physicians

Family Medicine
Geriatric Medicine

(CT)
2207V00000XAllopathic & Osteopathic Physicians

Obstetrics & Gynecology

(CT)
3208000000XAllopathic & Osteopathic Physicians

Pediatrics

(CT)
4363AM0700XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant
Medical

(CT)

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MARISA PELLERIN

Authorized Official Title
CREDENTIALING/ENROLLMENT
Authorized Official Phone
(860) 358-4821

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
07D0720274
Facility Type
Physician Office
Certificate Effective Date
December 23, 2023
Certificate Expiration Date
December 22, 2025
Laboratory Director
JOSEPH SEMPLE MD
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Family Practice Group East Hampton in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1114062114, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 46. The final step is to find the difference between that total and the next multiple of ten (50 - 46 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
1
Doubled → 2
Pos 4
4
Unchanged
Pos 5
0
Doubled → 0
Pos 6
6
Unchanged
Pos 7
2
Doubled → 4
Pos 8
1
Unchanged
Pos 9
1
Doubled → 2
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 0 → 0 2 → 4 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 2 + 4 + 0 + 6 + 4 + 1 + 2 + 24 = 46

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 46 is 50. The difference is the calculated check digit.

50 - 46 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1114062114.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Specialist
42 E HIGH ST, SUITE 203
EAST HAMPTON, CT 06424
Pediatrics
42 E HIGH ST
EAST HAMPTON, CT 06424

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114062114, enumerated as an "organization" on February 20, 2007.

The provider is located at 42 E HIGH ST EAST HAMPTON, CT 06424 and the phone number is (860) 344-6394.

Family Medicine with taxonomy code 207Q00000X.