SOUTHEASTERN CT PRIMARY CARE, LLC
NPI 1134591696
Clinic/Center - Primary Care in Groton, CT
About Southeastern Ct Primary Care, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHEASTERN CT PRIMARY CARE, LLC (NPI 1134591696) is a healthcare organization registered as a primary care in Groton, Connecticut and active in the NPI registry since October 2015. The organization holds a CLIA Waiver certificate valid through July 26, 2028, maintains a secondary practice location in Niantic, and lists Rosalinda G Gaona, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southeastern Ct Primary Care, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Southeastern Ct Primary Care, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
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 07D2116496
Southeastern Ct Primary Care, LLC · Groton, CTFrequently 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 Southeastern Ct Primary Care, LLC's NPI number?
The NPI number for Southeastern Ct Primary Care, LLC is 1134591696. It was assigned to this organization in the NPPES registry on October 23, 2015.
Where is Southeastern Ct Primary Care, LLC located?
Southeastern Ct Primary Care, LLC is located at 495 Gold Star Hwy Ste 112, Groton, CT 06340. The listed phone number is (860) 691-8084.
What is Southeastern Ct Primary Care, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Southeastern Ct Primary Care, LLC enrolled in Medicare?
Yes. Southeastern Ct Primary Care, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southeastern Ct Primary Care, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Southeastern Ct Primary Care, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Southeastern Ct Primary Care, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 07D2116496) is associated with this NPI, valid through July 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Southeastern Ct Primary Care, LLC was last updated on January 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.
# Southeastern Ct Primary Care, Llc · NPI 1134591696
Primary Care organization in Groton, Connecticut. Organization record, active in the CMS NPPES registry since October 23, 2015.
## Identity
- **NPI:** 1134591696 (Entity type: Organization)
- **Enumerated:** October 23, 2015
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Rosalinda Gaona, PHYSICIAN
## Practice location
- **Address:** 495 GOLD STAR HWY STE 112, Groton, CT 06340-6229
- **Phone:** (860) 691-8084 · **Fax:** (860) 691-1195
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 16, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1134591696) · Data from the CMS NPPES public registry.