MASHANTUCKET PEQUOT TRIBAL COUNCIL
NPI 1508140922
Family Medicine in Ledyard, CT
About Mashantucket Pequot Tribal Council NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MASHANTUCKET PEQUOT TRIBAL COUNCIL (NPI 1508140922) is a healthcare organization registered as a family medicine in Ledyard, Connecticut and active in the NPI registry since October 2011. The organization holds a CLIA Waiver certificate valid through December 15, 2027 and lists Shanna Tari Reels, Tribal Health Services Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 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)
Mashantucket Pequot Tribal Council is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Mashantucket Pequot Tribal Council, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
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 07D0968602
Mashantucket Pequot Tribal Health Dept · Ledyard, 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 Mashantucket Pequot Tribal Council's NPI number?
The NPI number for Mashantucket Pequot Tribal Council is 1508140922. It was assigned to this organization in the NPPES registry on October 4, 2011.
Where is Mashantucket Pequot Tribal Council located?
Mashantucket Pequot Tribal Council is located at 75 Route 2, Ledyard, CT 06339. The listed phone number is (860) 312-8000.
What is Mashantucket Pequot Tribal Council's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Mashantucket Pequot Tribal Council enrolled in Medicare?
Yes. Mashantucket Pequot Tribal Council is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mashantucket Pequot Tribal Council?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Mashantucket Pequot Tribal Council, in Certified Clinical Nurse Specialist (CNS), Internal Medicine and Nurse Practitioner. 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. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Mashantucket Pequot Tribal Council hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 07D0968602) is associated with this NPI, valid through December 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Mashantucket Pequot Tribal Council was last updated on May 16, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Mashantucket Pequot Tribal Council · NPI 1508140922
Family Medicine organization in Ledyard, Connecticut. Organization record, active in the CMS NPPES registry since October 4, 2011.
## Identity
- **NPI:** 1508140922 (Entity type: Organization)
- **Enumerated:** October 4, 2011
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Shanna Reels, TRIBAL HEALTH SERVICES DIRECTOR
## Practice location
- **Address:** 75 ROUTE 2, Ledyard, CT 06339-1128
- **Phone:** (860) 312-8000 · **Fax:** (860) 312-8001
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (2), Nurse Practitioner (2), Certified Clinical Nurse Specialist (CNS) (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 16, 2014
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1508140922) · Data from the CMS NPPES public registry.