Mallory Fossa, PNP-PC
Mallory Fossa, PNP-PC is a Pediatric Anesthesiology Physician in Hartford, CT, registered under NPI 1780059030. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 282 WASHINGTON ST, Hartford, CT 06106. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 95003548 | CA | Pediatric Nurse Practitioner |
| 12.008276 | CT | Pediatric Nurse Practitioner |
| 95003548 | CA | Pediatric Anesthesiology Physician primary |
Licences are recorded in 2 states: CA, CT. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Nurse Practitioner
- PAC ID
- 1557632106
Enrolled in Medicare 2 times, across 2 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Connecticut | I20190822002533 | Practitioner - Nurse Practitioner |
| Massachusetts | I20230110001798 | Practitioner - Nurse Practitioner |
Medicare enrolment is recorded as approved under the provider type Practitioner - Nurse Practitioner. There are 2 separate enrolment records across 2 states (CT, MA). 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: California and Connecticut. The practice address on file is in Hartford, 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.
- Licence
- 12.008276
- Specialty
- Pediatric Nurse Practitioner
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 Pediatric Anesthesiology covers
An anesthesiologist who has had additional skill and experience in and is primarily concerned with the anesthesia, sedation, and pain management needs of infants and children. A pediatric anesthesiologist generally provides services including the evaluation of complex medical problems in infants and children when surgery is necessary, planning and care for children before and after surgery, pain control, anesthesia and sedation for any procedures out of the operating room such as MRI, CT scan, and radiation therapy. NUCC Health Care Provider Taxonomy, code 207LP3000X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 363LP0200X | Pediatric Nurse Practitioner Pediatrics | 95003548 | CA | |
| 363LP0200X | Pediatric Nurse Practitioner Pediatrics | 12.008276 | CT | |
| 207LP3000X | Pediatric Anesthesiology Physician Pediatric Anesthesiology | 95003548 | CA | primary |
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.
| NPI | 1780059030 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Dec 10, 2015 |
| Last updated | Sep 12, 2022 |
| Status | Active |
| Sole proprietor | Yes |
| Gender | Female |
| Credential | PNP-PC |
| Practice address |
282 WASHINGTON ST Hartford, CT 06106 (860) 837-5207 |
| Mailing address |
3701 WILSHIRE BLVD SUITE 600 Los Angeles, CA 90010 |
Number check
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 | 8 | 0 | 0 | 5 | 9 | 0 | 3 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 7 | 7 | 0 | 0 | 5 | 9 | 0 | 6 |
Sum = 60 · next multiple of 10 = 60 · check digit = 0 · actual last digit = 0
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.