CONNECTICUT SURGICAL GROUP PC NPI 1518940204

NPI Information

NPI: 1518940204
Provider Name: CONNECTICUT SURGICAL GROUP, PC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization

CLIA Number: 07D2173765

Address:
120 SIMSBURY RD
AVON, CT
ZIP 06001
Phone: (860) 246-2071
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CONNECTICUT SURGICAL GROUP, PC is a durable medical equipment medical supplies in Avon, CT. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. CONNECTICUT SURGICAL GROUP, PC NPI is 1518940204. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

120 SIMSBURY RD
AVON, CT
ZIP 06001-735
Phone: (860) 246-2071
Fax: (860) 678-8262

The provider's authorized official is Douglas C Mckell .
The authorized official title is Chief Administrative Officer and has the following contact phone number (860) 524-4326.

The CLIA number assigned to this NPI record is 07D2173765 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/28/2005 and was last updated on 8/11/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	208600000X	Surgery		No
2	208200000X	Plastic Surgery		No
3	2082S0105X	Plastic Surgery	Surgery of the Hand	No
4	2086S0105X	Surgery	Surgery of the Hand	No
5	2086S0122X	Surgery	Plastic and Reconstructive Surgery	No
6	2086S0129X	Surgery	Vascular Surgery	No
7	2086X0206X	Surgery	Surgical Oncology	No
8	208800000X	Urology		No
9	208C00000X	Colon & Rectal Surgery		No
10	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery)		No
11	2085R0202X	Radiology	Diagnostic Radiology	No
12	2085U0001X	Radiology	Diagnostic Ultrasound	No
13	213E00000X	Podiatrist		No
14	213ES0103X	Podiatrist	Foot & Ankle Surgery	No
15	332B00000X	Durable Medical Equipment & Medical Supplies		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C01687	MEDICARE ID-TYPE UNSPECIFIED
2	004169711	MEDICAID	CONNECTICUT
3	1028630002	MEDICARE NSC	CONNECTICUT
4	004201034	MEDICAID	CONNECTICUT
5	87090	OTHER	CONNECTICUT	AETNA
6	=========019	OTHER	CONNECTICUT	TRICARE
7	9781188	MEDICAID	MASSACHUSETTS
8	01926310	MEDICAID	NEW YORK
9	0000S03059	OTHER	CONNECTICUT	HEALTH NET
10	50CONNSURCT01	OTHER	CONNECTICUT	ANTHEM BCBS
11	004139350	MEDICAID	CONNECTICUT
12	C02779	MEDICARE PIN	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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