NATALIE MARIE CONCANNON PA
NPI 1720422645
Physician Assistant - Medical in Waterford, CT
About Natalie Marie Concannon Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NATALIE MARIE CONCANNON PA (NPI 1720422645) is an individual medical provider in Waterford, Connecticut, licensed in Connecticut (5660) and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS, maintains a secondary practice location in Minneapolis, and is a graduate of Yale University School Of Medicine (2012).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Natalie Marie Concannon Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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 Natalie Concannon's NPI number?
The NPI number for Natalie Concannon is 1720422645. It was assigned to this individual provider in the NPPES registry on April 22, 2013. The provider is also known as Natalie Marie Grome Pa-C.
Where is Natalie Concannon located?
Natalie Concannon practices at 5 Dayton Rd Ste 205, Waterford, CT 06385. The listed phone number is (860) 443-4445.
What is Natalie Concannon's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Natalie Concannon enrolled in Medicare?
Yes. Natalie Concannon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Natalie Concannon was last updated on October 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Natalie Marie Concannon, PA · NPI 1720422645
Medical physician in Waterford, Connecticut. Individual provider, active in the CMS NPPES registry since April 22, 2013.
## Identity
- **NPI:** 1720422645 (Entity type: Individual)
- **Enumerated:** April 22, 2013
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** 5660 (Connecticut)
- **Sole proprietor:** No
## Practice location
- **Address:** 5 DAYTON RD STE 205, Waterford, CT 06385-4279
- **Phone:** (860) 443-4445 · **Fax:** (860) 447-8961
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Yale University School Of Medicine, class of 2012
## Record status
- **NPPES last updated:** October 23, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1720422645) · Data from the CMS NPPES public registry.