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MITRA MARVASTI-SITTERLY
NPI 1154065514
Dentist - Pediatric Dentistry in Weatogue, CT

Active since April 22, 2022PECOS Enrolled
381 HOPMEADOW ST STE 202, WEATOGUE, CT 06089(860) 658-7548 Get Directions Write a Review

NPPES record last updated: June 25, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 25, 2025, May 19, 2023, Aug 8, 2022 and 1 more (4 updates tracked since 2022).

About Mitra Marvasti-sitterly NPPES

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

MITRA MARVASTI-SITTERLY (NPI 1154065514) is an individual pediatric dentistry provider in Weatogue, Connecticut, licensed in Connecticut (13636) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Chicopee.

NPPES Registry Identity

NPI1154065514
Entity TypeIndividualFemale
Primary Taxonomy1223P0221X
Provider Legal NameMITRA MARVASTI-SITTERLY
Location Address381 HOPMEADOW ST STE 202Weatogue, CT 06089-9697
Mailing Address181 Partridge LndgGlastonbury, CT 06033-2849 · (860) 692-8127
Phone(860) 658-7548
Sole ProprietorYes
Enumeration DateApril 22, 2022
Last NPPES UpdateJune 25, 20254 updates tracked since enumeration
NPPES CertifiedJune 25, 2025
✔ NPI 1154065514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Licenses✔ Licensed in CT · 13636✔ Licensed in MA · DN1859415
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Also ListedDentist · General PracticeTaxonomy 1223G0001X · License DN1859415 (MA), 13636 (CT)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 13758 (CT)
381 HOPMEADOW ST STE 202, Weatogue, CT 06089
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Secondary Practice Location 1

Location 121 Bay State RdChicopee, MA 01020-1521 · Phone (860) 692-8127

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, BEST Life and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mitra Marvasti-sitterly is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 06089 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
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Mitra Marvasti-sitterly's NPI number?

The NPI number for Mitra Marvasti-sitterly is 1154065514. It was assigned to this individual provider in the NPPES registry on April 22, 2022.

Where is Mitra Marvasti-sitterly located?

Mitra Marvasti-sitterly practices at 381 Hopmeadow St Ste 202, Weatogue, CT 06089. The listed phone number is (860) 658-7548.

What is Mitra Marvasti-sitterly's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Is Mitra Marvasti-sitterly enrolled in Medicare?

Yes. Mitra Marvasti-sitterly is registered in the Medicare PECOS enrollment system.

What insurance does Mitra Marvasti-sitterly accept?

Health plans from Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 7 other insurers list Mitra Marvasti-sitterly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mitra Marvasti-sitterly was last updated on June 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.