Individual provider

Natalie Concannon, PA

Medical Physician Assistant Medicare enrolled

Natalie Concannon, PA is a Medical Physician Assistant in Waterford, CT, registered under NPI 1720422645.

Getting there

The practice address on file is 5 DAYTON RD STE 205, Waterford, CT 06385. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

5 DAYTON RD STE 205, Waterford, CT 06385 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
5660 CT Medical Physician Assistant primary
25MP00473600 NJ Medical Physician Assistant

Licences are recorded in 2 states: CT, NJ. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Physician Assistant
PAC ID
9133358591

Enrolled in Medicare 3 times, across 3 states:

StateEnrollment IDProvider type
New York I20141028000325 Practitioner - Physician Assistant
New Jersey I20181107001702 Practitioner - Physician Assistant
Connecticut I20251104002671 Practitioner - Physician Assistant

Medicare enrolment is recorded as approved under the provider type Practitioner - Physician Assistant. There are 3 separate enrolment records across 3 states (NY, NJ, CT). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Connecticut and New Jersey. The practice address on file is in Waterford, CT, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

CT Connecticut practice address
Licence
5660
Specialty
Medical Physician Assistant
Verify with the CT board →
NJ New Jersey
Licence
25MP00473600
Specialty
Medical Physician Assistant
Verify with the NJ board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Medical covers

Definition to come... NUCC Health Care Provider Taxonomy, code 363AM0700X
Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Medical

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
363AM0700X Medical Physician Assistant Medical 5660 CT primary
363AM0700X Medical Physician Assistant Medical 25MP00473600 NJ

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1720422645 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateApr 22, 2013
Last updatedOct 23, 2025
StatusActive
Sole proprietorNo
CredentialPA
Practice address 5 DAYTON RD STE 205
Waterford, CT 06385
(860) 443-4445
Fax (860) 447-8961
Mailing address 136 MOUNTAINVIEW BLVD
Basking Ridge, NJ 07920
This record was updated on Oct 23, 2025, which is recent enough that the contact details are likely still accurate.

Number check

1720422645 passes the NPI check digit test The final digit 5 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 7 2 0 4 2 2 6 4
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 7 4 0 8 2 4 6 8

Sum = 65 · next multiple of 10 = 70 · check digit = 5 · actual last digit = 5

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1720422645?
NPI 1720422645 is the National Provider Identifier assigned to Natalie Concannon, PA in Waterford, CT. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Medical cover?
Definition to come...
How do I contact Natalie Concannon, PA?
The phone number on file with NPPES is (860) 443-4445, last updated Oct 23, 2025. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Natalie Concannon, PA accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1720422645 a valid number?
Yes. 1720422645 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.