SUFFIELD PEDIATRIC AND ADOLESCENT MEDICINE PLLC
NPI 1841075264
Nurse Practitioner - Pediatrics in Suffield, CT

Active since August 25, 2023CLIA 07D2296273 · Waiver
230C MOUNTAIN RD, SUFFIELD, CT 06078(860) 836-5416 Get Directions Write a Review

NPPES record last updated: August 25, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Suffield Pediatric And Adolescent Medicine Pllc NPPES

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

SUFFIELD PEDIATRIC AND ADOLESCENT MEDICINE PLLC (NPI 1841075264) is a healthcare organization registered as a pediatrics in Suffield, Connecticut and active in the NPI registry since August 2023. The organization holds a CLIA Waiver certificate valid through December 25, 2027 and lists Melissa J Lee, Owner, as its authorized official.

NPPES Registry Identity

NPI1841075264
Entity TypeOrganization
Primary Taxonomy363LP0200X
Legal Business NameSUFFIELD PEDIATRIC AND ADOLESCENT MEDICINE PLLC
Location Address230C MOUNTAIN RDSuffield, CT 06078-3019
Mailing Address65 Brookside DrSuffield, CT 06078-1530
Organization SubpartNo
Authorized OfficialMelissa J LeeOwner · (860) 836-5416
Enumeration DateAugust 25, 2023
NPPES CertifiedAugust 25, 2023
NPI 1841075264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
230C MOUNTAIN RD, Suffield, CT 06078

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 07D2296273

Suffield Pediatric And Adolescent Medicine · Suffield, CT
Active · expires Dec 25, 2027
CLIA Number07D2296273
Laboratory TypePractitioner Other
Certificate Effective DateDecember 26, 2025
Certificate Expiration DateDecember 25, 2027
Laboratory DirectorMelissa Jenkins Lee
Laboratory Phone(860) 836-5416
Laboratory LocationSuffield Pediatric And Adolescent Medicine230C Mountain Road, Suffield, CT 06078
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Physical Therapy)
230C MOUNTAIN RD
SUFFIELD, CT 06078

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 Suffield Pediatric And Adolescent Medicine PLLC's NPI number?

The NPI number for Suffield Pediatric And Adolescent Medicine PLLC is 1841075264. It was assigned to this organization in the NPPES registry on August 25, 2023.

Where is Suffield Pediatric And Adolescent Medicine PLLC located?

Suffield Pediatric And Adolescent Medicine PLLC is located at 230C Mountain Rd, Suffield, CT 06078. The listed phone number is (860) 836-5416.

What is Suffield Pediatric And Adolescent Medicine PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Does Suffield Pediatric And Adolescent Medicine PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D2296273) is associated with this NPI, valid through December 25, 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 Suffield Pediatric And Adolescent Medicine PLLC was last updated on August 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.