MALLORY SIMPSON BREITMAIER FNP
NPI 1265786917
Nurse Practitioner - Family in Colchester, CT
About Mallory Simpson Breitmaier Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MALLORY SIMPSON BREITMAIER FNP (NPI 1265786917) is an individual family provider in Colchester, Connecticut, licensed in Connecticut (5210) and active in the NPI registry since November 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in Hartford.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mallory Simpson Breitmaier Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mallory Breitmaier reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Hartford, CT 06106
- Reassigned Medicare billing, Connecticut enrollment
- 601 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 06415 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
COLCHESTER, CT 06415
COLCHESTER, CT 06415
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 Mallory Breitmaier's NPI number?
The NPI number for Mallory Breitmaier is 1265786917. It was assigned to this individual provider in the NPPES registry on November 2, 2012.
Where is Mallory Breitmaier located?
Mallory Breitmaier practices at 119 S Main St Minuteclinic, Colchester, CT 06415. The listed phone number is (401) 714-5502.
What is Mallory Breitmaier's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Mallory Breitmaier enrolled in Medicare?
Yes. Mallory Breitmaier is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mallory Breitmaier's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mallory Breitmaier reassigns Medicare benefits to Connecticut Children's Specialty Group, Inc. (Hartford, CT). The 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 Mallory Breitmaier's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mallory Breitmaier was last updated on February 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Mallory Simpson Breitmaier, FNP · NPI 1265786917
Family physician in Colchester, Connecticut. Individual provider, active in the CMS NPPES registry since November 2, 2012.
## Identity
- **NPI:** 1265786917 (Entity type: Individual)
- **Enumerated:** November 2, 2012
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 5210 (Connecticut)
- **Sole proprietor:** No
## Practice location
- **Address:** 119 S MAIN ST, MINUTECLINIC, Colchester, CT 06415-1456
- **Phone:** (401) 714-5502
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Connecticut Children's Specialty Group, Inc. (NPI 1669448882, Hartford, CT), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 10, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1265786917) · Data from the CMS NPPES public registry.