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PHILIP MIRACLE ENNIN JR. APRN
NPI 1124843503
Nurse Practitioner in Plainville, CT

Active since November 20, 2024PECOS EnrolledAccepts Medicare Assignment
269 FARMINGTON AVE, PLAINVILLE, CT 06062(860) 655-2432 Get Directions Write a Review

NPPES record last updated: February 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 25, 2025, Nov 20, 2024 (2 updates tracked since 2024).

About Philip Miracle Ennin Jr. Aprn NPPES

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

PHILIP MIRACLE ENNIN JR. APRN (NPI 1124843503) is an individual nurse practitioner in Plainville, Connecticut, licensed in Connecticut (14447) and active in the NPI registry since November 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1124843503
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NamePHILIP MIRACLE ENNIN JR.Credential: APRN
Location Address269 FARMINGTON AVEPlainville, CT 06062-1335
Mailing Address75 Gordon LnEast Hartford, CT 06118-2222 · (860) 655-2432
Phone(860) 655-2432
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateNovember 20, 2024
Last NPPES UpdateFebruary 25, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 25, 2025
✔ NPI 1124843503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CT · 14447
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedRegistered NurseTaxonomy 163W00000X · License 164301 (CT)
269 FARMINGTON AVE, Plainville, CT 06062
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Philip Miracle Ennin Jr. Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5294257150
PECOS Enrollment IDI20250320000378
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06062 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

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

VANESSA ANNE O'DONNELL DPT
Physical Therapist
269 FARMINGTON AVE
PLAINVILLE, CT 06062
Capitol Planning Region (860) 747-1637
DR. JACOB LANG
Physical Therapist
269 FARMINGTON AVE
PLAINVILLE, CT 06062
Capitol Planning Region (860) 747-1637
DR. ANTHONY ANIELLO DPT
Physical Therapist
269 FARMINGTON AVE
PLAINVILLE, CT 06062
Capitol Planning Region (860) 747-1637
PLAINVILLE HEALTH CARE CENTER INC.
Skilled Nursing Facility
269 FARMINGTON AVE
PLAINVILLE, CT 06062
Capitol Planning Region (860) 747-1637

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 Philip Ennin's NPI number?

The NPI number for Philip Ennin is 1124843503. It was assigned to this individual provider in the NPPES registry on November 20, 2024.

Where is Philip Ennin located?

Philip Ennin practices at 269 Farmington Ave, Plainville, CT 06062. The listed phone number is (860) 655-2432.

What is Philip Ennin's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Philip Ennin enrolled in Medicare?

Yes. Philip Ennin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Philip Ennin was last updated on February 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.