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MANSFIELD FAMILY PRACTICE LLC
NPI 1265546956
Family Medicine in Storrs, CT

Active since August 18, 2006
34 PROFESSIONAL PARK ROAD, STORRS, CT 06268(860) 487-0002(860) 429-1663 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jul 21, 2022, Aug 22, 2020 (2 updates tracked since 2020).

About Mansfield Family Practice Llc NPPES

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

MANSFIELD FAMILY PRACTICE LLC (NPI 1265546956) is a healthcare organization registered as a family medicine in Storrs, Connecticut and active in the NPI registry since August 2006. The organization lists Kelly Wyse, Medical Records, as its authorized official.

NPPES Registry Identity

NPI1265546956
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMANSFIELD FAMILY PRACTICE LLC
Location Address34 PROFESSIONAL PARK ROADStorrs, CT 06268
Mailing Address34 Professional Park RoadStorrs, CT 06268 · (860) 487-0002 · Fax (860) 429-1663
Phone(860) 487-0002
Fax(860) 429-1663
Organization SubpartNo
Authorized OfficialKelly WyseMedical Records · (860) 487-0002
Enumeration DateAugust 18, 2006
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1265546956 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
34 PROFESSIONAL PARK ROAD, Storrs, CT 06268
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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

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 07D0095182

Mansfield Family Practice LLC · Storrs, CT
Expired · Jul 31, 2026
CLIA Number07D0095182
Laboratory TypePhysician Office
Certificate Effective DateAugust 1, 2024
Certificate Expiration DateJuly 31, 2026
Laboratory DirectorAyaz T. Madraswalla
Laboratory Phone(860) 487-0002
Laboratory LocationMansfield Family Practice LLC34 Professional Park Road, Storrs, CT 06268
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Mansfield Family Practice LLC's NPI number?

The NPI number for Mansfield Family Practice LLC is 1265546956. It was assigned to this organization in the NPPES registry on August 18, 2006.

Where is Mansfield Family Practice LLC located?

Mansfield Family Practice LLC is located at 34 Professional Park Road, Storrs, CT 06268. The listed phone number is (860) 487-0002.

What is Mansfield Family Practice LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Mansfield Family Practice LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.