SURGICAL SPECIALISTS PC (NPI# 1497874945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497874945 |
| Entity Type | Organization |
| Organization Name | SURGICAL SPECIALISTS PC |
| Practice Address |
134 Grandview Ave Suite 209 Waterbury CT 06708-2507 |
| Practice Telephone | 2037556666 |
| Practice Fax Number | 2035736735 |
| Mailing Telephone | 2037556666 |
| Mailing Fax Number | 2035736735 |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2009-11-03 |
| Authorized Official Name | DR. JAYAKARA SHETTY (PRESIDENT) |
| Authorized Official Telephone | 2037556666 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 024773 | CT | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | RAILROAD MEDICARE | 020045404 | 01 |
| CT | AETNA USH | 556517 | 01 |
| CT | PREFERRED ONE | 130555 | 01 |
| CT | 001247733 | 05 | |
| CT | WELLCARE | 130555 | 01 |
| CT | OXFORD HEALTHPLAN | NHS039 | 01 |
| CT | ANTHEM BCBS | 010024773CT02 | 01 |
| CT | CONNECTICARE | 024773 | 01 |
| CT | GHI | 0199318 | 01 |
| CT | HEALTHNET | 0R0463 | 01 |
| Street Address |
134 GRANDVIEW AVE SUITE 209 |
| City | WATERBURY |
| State | CT |
| Zip Code | 06708-2507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114928827 | Specialists In Women's Healthcare PC | Advanced Practice Midwife | 134 Grandview Ave, Ste 210, Waterbury, CT 06708-2507 | 2005-08-03 |
| 1245714567 | Barbara Rymer | Nurse Practitioner | 134 Grandview Ave, Waterbury, CT 06708-2507 | 2018-09-21 |
| 1407120751 | Vanessa Daou | Advanced Practice Midwife | 134 Grandview Ave, Suite 210, Waterbury, CT 06708-2507 | 2012-03-05 |
| 1205144300 | Daniel P Baxter | Physician Assistant | 134 Grandview Ave, Suite 101, Waterbury, CT 06708-2507 | 2010-09-23 |
| 1811204985 | Kathleen Lea Sullivan | Nurse Practitioner | 134 Grandview Ave, 208, Waterbury, CT 06708-2507 | 2010-09-09 |
| 1114232832 | Theresa F Piliero | Nurse Practitioner | 134 Grandview Ave, Suite 202, Waterbury, CT 06708-2507 | 2010-08-18 |
| 1194956045 | Kristen D Graff Beardslee | Advanced Practice Midwife | 134 Grandview Ave, Suite 210, Waterbury, CT 06708-2507 | 2009-07-27 |
| 1922245745 | Kelly Lynn Palmer | Occupational Therapist | 134 Grandview Ave, Waterbury, CT 06708-2507 | 2009-01-15 |
| 1548423973 | Jenna A Logiudice | Obstetrics & Gynecology | 134 Grandview Ave, Suite 210, Waterbury, CT 06708-2507 | 2008-07-07 |
| 1285821603 | Cybill Shelby Thomas | Nurse Practitioner | 134 Grandview Ave, Waterbury, CT 06708-2507 | 2007-09-30 |
| Find all providers in the same location | ||||
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912940784 | Thomas R. Alosco, M.d., P.C. | Specialist | 1336 W Main St, Suite 1a, Waterbury, CT 06708-3122 | 2006-06-13 |
| 1518955236 | David C Levi | Specialist | 1320 W Main St Unit 5, Waterbury, CT 06708-3119 | 2005-10-06 |
| 1467755900 | Pain & Spine Specialists of Connecticut, LLC | Specialist | 1320 W Main St, Bldg 2, Waterbury, CT 06708-3119 | 2010-12-06 |
| 1780839977 | A.aziz Richi, Md, LLC | Specialist | 1389 W Main St, Suite 322, Waterbury, CT 06708-3104 | 2008-12-01 |
| 1255584314 | Abdulmasih Zarif, Md, LLC | Specialist | 1389 W Main St, Suite 321, Waterbury, CT 06708-3104 | 2008-11-02 |
| 1689846719 | David G. Reis Md, LLC | Specialist | 140 Grandview Ave, Suite 204, Waterbury, CT 06708-2505 | 2008-03-28 |
| 1699960203 | Connecticut Pain Care, P.C. | Specialist | 1389 W Main St, Suite #123, Waterbury, CT 06708-3104 | 2007-09-07 |
| 1215065503 | Stephen Harris | Specialist | 2457 E Main St, Waterbury, CT 06705-2685 | 2007-03-01 |
| 1538239561 | Patricia B Skiff | Specialist | 117 Sharon Rd, Mall View Plaza, Waterbury, CT 06705-4000 | 2006-11-08 |
| 1558430785 | Jenny M Braddock | Specialist | 117 Sharon Rd, Mall View Plaza, Waterbury, CT 06705-4000 | 2006-11-06 |
| 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.