MIDSTATE MEDICAL GROUP, PC (NPI# 1427089598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427089598 |
| Entity Type | Organization |
| Organization Name | MIDSTATE MEDICAL GROUP, PC |
| Practice Address |
98 Main St Ste 300 Southington CT 06489-2500 |
| Practice Telephone | 2036945580 |
| Practice Fax Number | 8606200446 |
| Mailing Telephone | 2036945580 |
| Mailing Fax Number | 8606200446 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2012-08-24 |
| Authorized Official Name | RALPH BECKER (VICE PRESIDENT, FINANCE) |
| Authorized Official Telephone | 8605457602 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RS0010X |
Internal Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004260022 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356361315 | Midstate Medical Group, PC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 435 Lewis Avenue, Midstate Medical Group, PC, Meriden, CT 06451 | 2006-07-20 |
| Street Address |
98 MAIN ST STE 300 |
| City | SOUTHINGTON |
| State | CT |
| Zip Code | 06489-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467087783 | Shankar Panwar | Counselor | K 11, 1783 Meriden Waterbury Tpke, Southington, CT 06489 | 2020-03-06 |
| 1235771056 | Kathleen Rebecca Mckinney | Music Therapist | 196 Queen St., Southington, CT 06489 | 2019-10-14 |
| 1336700103 | Julie Amanda Nichols | Behavioral Analyst | 1842 Meriden-waterbury Turnpike, Southington, CT 06489 | 2019-06-24 |
| 1396238960 | Kriston Ronalter | Physician Assistant | 775 Queen Street, Southington, CT 06489 | 2018-06-08 |
| 1366933582 | Cj's Counseling, LLC | Counselor | 17 Meriden Ave Ste 1a, Southington, CT 06489 | 2018-05-23 |
| 1104329887 | Koby Douglas Fowler | Chiropractor | 1095 West St Unit 1, Southington, CT 06489 | 2018-03-09 |
| 1447763131 | Samreen, LLC | Clinic/Center | 775 Queen St, Suite 2, Southington, CT 06489 | 2017-11-16 |
| 1902320724 | Michael Petit | Physical Therapist | 98 Main Street, 202, Southington, CT 06489 | 2017-08-02 |
| 1457712127 | Leslie Mclaughlin | Speech-Language Pathologist | 400 Flanders Rd, Southington, CT 06489 | 2016-03-09 |
| 1306219159 | Breanne Schnepf-hanbury | Counselor | 26 N Main St Ste 2b, Southington, CT 06489 | 2015-11-02 |
| Find all providers in zip 06489 | ||||
| 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 |
|---|---|---|---|---|
| 1588197230 | Isma Arif Mian | Internal Medicine | 462 Queen Street, Suite 301, Southington, CT 06489-1801 | 2017-04-10 |
| 1205959301 | Southington Urgent Care | Internal Medicine | 1131 West St Ste 1, Southington, CT 06489-6006 | 2007-04-06 |
| 1073532339 | Vincent M Leone | Internal Medicine | 1115 West Street, Southington, CT 06489-6006 | 2006-07-18 |
| 1063445161 | Andrew D Guest | Internal Medicine | 171 Liberty St, Southington, CT 06489 | 2006-07-09 |
| 1710986906 | Craig M Bogdanski | Internal Medicine | 825 Meriden Waterbury Tpke, Southington, CT 06489-4156 | 2005-07-19 |
| 1215934658 | Wilner Samson | Internal Medicine | 98 Main St, Southington, CT 06489-2500 | 2005-06-30 |
| 1841653904 | Setareh Alipourfetrati | Internal Medicine | 1115 West Street, Southington, CT 06489-6006 | 2016-04-05 |
| 1407233547 | Sana Idrees | Internal Medicine | 98 Main St, Southington, CT 06489 | 2015-04-27 |
| 1184993503 | Narinder Maheshwari | Internal Medicine | 1115 West St, Uconn Medical Group, Southington, CT 06489 | 2011-12-14 |
| 1770807281 | Dr. Leonard C. Glaser, M.d.p.c. | Internal Medicine | 360 N Main St, Suite 3, Southington, CT 06489-2503 | 2010-03-26 |
| Find all providers in SOUTHINGTON | ||||
| City | SOUTHINGTON |
| Zip Code | 06489 |
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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.