WESTSIDE MEDICAL GROUP (NPI# 1083724967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083724967 |
| Entity Type | Organization |
| Organization Name | WESTSIDE MEDICAL GROUP |
| Practice Address |
714 Chase Parkway Suite 6 Waterbury CT 06708-3939 |
| Practice Telephone | 2037554577 |
| Practice Fax Number | 2037563628 |
| Mailing Telephone | 2037554577 |
| Mailing Fax Number | 2037563628 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-01-23 |
| Authorized Official Name | DR. MARK LAWRENCE KRAUS (PRESIDENT) |
| Authorized Official Telephone | 2037554577 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004085800 | 05 | |
| BCBS | 50WESTSIDECT01 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | WESTSIDE MEDICAL GROUP, LLC | 4501 Upper Mt Vernon Rd, Evansville, IN 47712 |
| Street Address |
714 CHASE PARKWAY SUITE 6 |
| City | WATERBURY |
| State | CT |
| Zip Code | 06708-3939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548328495 | Chase Parkway Dental LLC | Dentist | 714 Chase Parkway, Waterbury, CT 06708 | 2006-12-04 |
| 1437225281 | William H Arguett | Dentist | 714 Chase Parkway, Suite 1, Waterbury, CT 06708 | 2006-11-24 |
| 1851493969 | Mark Lawrence Kraus | Internal Medicine | 714 Chase Parkway, Suite 6, Waterbury, CT 06708-3939 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952864787 | Sidhant Singh | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center,160 Robbins Street, Waterbury, CT 06708 | 2019-04-09 |
| 1023574753 | Santa Maria & Schneider D.m.d Waterbury LLC | Dentist | 276 Highland Ave., Waterbury, CT 06708 | 2019-02-19 |
| 1548766959 | Caroline Johnssen | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center, 160 Robbins Street, Waterbury, CT 06708 | 2018-04-04 |
| 1992209530 | Valley Wellness Consulting Group LLC | Social Worker | 969 W Main Street, Suite 3e, Waterbury, CT 06708 | 2018-03-20 |
| 1306346457 | C&s Family Dental Waterbury, LLC | Dentist | 1630 Watertown Ave, Waterbury, CT 06708 | 2018-02-15 |
| 1447759865 | Inurse Homecare, LLC. | Home Health | 140 Fulkerson Drive Unit 2c, Waterbury, CT 06708 | 2018-02-12 |
| 1619423977 | Robert Girard II | Counselor | 969 West Main Street, Suite 1 D, Waterbury, CT 06708 | 2016-08-28 |
| 1457734360 | Alternatives, Inc. | Intermediate Care Facility, Mentally Retarded | 148 Highview St, Waterbury, CT 06708 | 2015-07-09 |
| 1407266901 | Maria Munoz | Obstetrics & Gynecology | 140 Grandview Ave Ste 202, Waterbury, CT 06708 | 2014-05-06 |
| 1922420330 | Danielle Moraes | Social Worker | 276 Highland Av 2nd Fl North, Waterbury, CT 06708 | 2014-01-21 |
| Find all providers in zip 06708 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245750538 | Sameerah Ibtisam Rehmani | Internal Medicine | St Mary's Hospital, 56 Franklin Street, Waterbury, CT 06706 | 2017-06-27 |
| 1053799544 | Emily Pinto Taylor | Internal Medicine | 133 Scovill St Ste 300, Waterbury, CT 06706-1127 | 2015-05-15 |
| 1578849519 | Uday Shankar | Internal Medicine | 3801 E Main St Fl 2, Waterbury, CT 06705 | 2011-10-21 |
| 1275828261 | Bechoi Saleib | Internal Medicine | 1981 E Main St, 2nd Floor, Waterbury, CT 06705-1822 | 2011-06-17 |
| 1750525549 | Benjamin Bodnar | Internal Medicine | 95 Scovill St Fl 3, Waterbury, CT 06706-1113 | 2009-04-24 |
| 1588848766 | Tracy Lyn Rabin | Internal Medicine | 64 Robbins Street, Waterbury Hospital Campus, Main 3, Yale Primary Care Program, Waterbury, CT 06708 | 2007-12-24 |
| 1255549622 | Ashish Arora | Internal Medicine | 133 Scovill St Ste 104, Waterbury, CT 06706-1127 | 2007-05-18 |
| 1780782953 | Vidya Loganathan | Internal Medicine | 2457 E Main St Ste 1e, Waterbury, CT 06705-2684 | 2006-09-20 |
| 1922111632 | Thomas Owen Genese | Internal Medicine | 56 Franklin Street, St. Mary's Hospital - Dept of Medicine, Waterbury, CT 06706 | 2006-08-16 |
| 1063435170 | Donald G Rosenthal | Internal Medicine | 447 Meriden Rd, Waterbury, CT 06705 | 2006-07-26 |
| Find all providers in WATERBURY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.