STAFFORD MEDICAL GROUP LLC (NPI# 1518098698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518098698 |
| Entity Type | Organization |
| Organization Name | STAFFORD MEDICAL GROUP LLC |
| Practice Address |
146 Main St Somers CT 06071-1825 |
| Practice Telephone | 8607498018 |
| Practice Fax Number | 8603164015 |
| Mailing Telephone | 8607498018 |
| Mailing Fax Number | 8603164015 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2015-01-29 |
| Authorized Official Name | DR. SULTAN ALAM QURAISHI (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8605583624 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 30076 | CT | Allopathic & Osteopathic Physicians |
| N | 363L00000X | Nurse Practitioner | 5393 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207Q00000X | Family Medicine | 30076 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | BLUE CARE FAMILY PLAN | 130076400 | 01 |
| CT | OXFORD | HAS028 | 01 |
| CT | CONNECTICARE | 781160 | 01 |
| CT | ANTHEM | 010030076CT04 | 01 |
| CT | AETNA | 4245029 | 01 |
| CT | CIGNA | 5861484 | 01 |
| CT | UNITED HEALTHCARE | 00000898346 | 01 |
| CT | 217079 | 05 | |
| CT | HEALTHNET | 2V4565 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | STAFFORD MEDICAL GROUP LLC | 146 Main St, Somers, CT 06071 |
| Street Address |
146 MAIN ST |
| City | SOMERS |
| State | CT |
| Zip Code | 06071-1825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760957526 | Suzanne Marie Viger | Nurse Practitioner | 146 Main St, Somers, CT 06071-1214 | 2018-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649519885 | Bgc Counseling, LLC | Community/Behavioral Health | 53 Bilton Rd., Somers, CT 06071 | 2013-02-07 |
| 1972738383 | Robert F. Maier Md PC | Surgery | 9 Robert St, Somers, CT 06071 | 2009-05-29 |
| 1396916912 | Somers Family Practice, LLC | Family Medicine | 24 Battle Street, Suite 1a, Somers, CT 06071 | 2008-03-24 |
| 1043382344 | Michael John Clements | Family Medicine | 100 Bilton Rd, Somers, CT 06071 | 2006-11-14 |
| 1639303381 | Stephanie L. Katz | Dentist | Osborn Ci 335 Bilton Rd, Suite 306, Somers, CT 06071-0607 | 2009-05-11 |
| 1043501885 | Shawna Lynne Harmon | Dentist | 335 Bilton Rd, Pob 100, Somers, CT 06071-1044 | 2011-04-27 |
| 1861437477 | Gerard George Gagne Jr. | Psychiatry & Neurology | 287 Bilton Rd, Somers, CT 06071-1044 | 2006-06-18 |
| 1023167319 | Jill V. Haga | Counselor | 287 Bilton Rd, Somers, CT 06071-1044 | 2007-01-09 |
| 1750717732 | Nancy R Rodriguez | Dietitian, Registered | 646 Hall Hill Rd, Somers, CT 06071-1057 | 2013-09-23 |
| 1396046744 | Leah Irene Cressotti | Clinical Nurse Specialist | 100 Bilton Rd, Somers, CT 06071-1059 | 2010-11-16 |
| Find all providers in zip 06071 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316209760 | Germain Armand Bianchi | Family Medicine | 14 Heritage Dr, Somers, CT 06071-1908 | 2012-06-12 |
| 1396916912 | Somers Family Practice, LLC | Family Medicine | 24 Battle Street, Suite 1a, Somers, CT 06071 | 2008-03-24 |
| 1043382344 | Michael John Clements | Family Medicine | 100 Bilton Rd, Somers, CT 06071 | 2006-11-14 |
| 1538130836 | Ian Sterling Tucker | Family Medicine | 24 Battle St, Suite 1a, Somers, CT 06071-1629 | 2006-01-27 |
| 1982915088 | Christopher Jason Robles | Family Medicine | 325 Route 100, Somers, NY 10589-3227 | 2010-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225638299 | Alyssa Mary Brown | Family Medicine | 82 Welles Dr, Newington, CT 06111-2625 | 2020-10-29 |
| 1598370389 | Korinne Fern Croce X | Family Medicine | 52 Meadowood Dr, New Milford, CT 06776-5732 | 2020-09-09 |
| 1619580263 | Chelsea Nicole Alves | Family Medicine | 111 Connecticut Blvd, East Hartford, CT 06108-3015 | 2020-08-24 |
| 1679108492 | Sky Health Group PC | Family Medicine | 64 Blue Ridge Drive, Waterbury, CT 06704 | 2020-03-12 |
| 1598397192 | Healthmed Family Care | Family Medicine | 1209 S Broad St, Wallingford, CT 06492-1714 | 2020-02-11 |
| 1457991333 | Diane Iannini | Family Medicine | 16 Bridge End Farm Ln, Sandy Hook, CT 06482-1055 | 2020-01-08 |
| 1396382685 | Optimum Regenerative Care LLC | Family Medicine | 46 Benson Dr, Danbury, CT 06810-7231 | 2019-12-05 |
| 1801455761 | Steven John Rigatti | Family Medicine | 157 Uconn Ave, Glastonbury, CT 06033-1348 | 2019-06-13 |
| 1063071017 | Better Life- Better Health Pllc | Family Medicine | 728 Broad Street Ext # B, Waterford, CT 06385-1345 | 2019-06-12 |
| 1336703586 | Shazia Josephine Joseph | Family Medicine | 12 Village St Ste 5, North Haven, CT 06473-3828 | 2019-04-23 |
| Find all providers with the same taxonomy | ||||
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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.