STAYWELL HEALTH CARE INC (NPI# 1831580745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831580745 |
| Entity Type | Organization |
| Organization Name | STAYWELL HEALTH CARE INC |
| Other Organization Name | STAYWELL CHC |
| Practice Address |
95 Scovill St 3rd Floor Pavillion B Waterbury CT 06706-1113 |
| Mailing Address |
80 Phoenix Ave Suite 201 Waterbury CT 06702-1418 |
| Practice Telephone | 2038054930 |
| Practice Fax Number | 8889654027 |
| Mailing Telephone | 2037568021 |
| Mailing Fax Number | 2035969038 |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2015-02-13 |
| Authorized Official Name | DONALD THOMPSON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2037568021 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
0000744 | CT | Ambulatory Health Care Facilities |
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM BCBS | 1154342335 | 01 |
| CT | 004235976 | 05 |
| Other Name | Type Code |
|---|---|
| Staywell CHC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861024 | Staywell Health Care Inc | Clinic/Center | 160 Robbins St Ste 2, Waterbury, CT 06708-2652 | 2020-11-03 |
| 1982151635 | Staywell Health Care Inc | Family Medicine | 30 Church St, Naugatuck, CT 06770-4112 | 2016-09-09 |
| 1083022230 | Staywell Health Care Inc | Family Medicine | 402 E Main St, Waterbury, CT 06702-1701 | 2014-07-31 |
| Street Address |
95 SCOVILL ST 3RD FLOOR PAVILLION B |
| City | WATERBURY |
| State | CT |
| Zip Code | 06706-1113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477591097 | Samer Ein Alshaeba | Internal Medicine | 95 Scovill St, Waterbury, CT 06706-1113 | 2006-06-04 |
| 1588961742 | Kathryn Anne Loughlin | Social Worker | 95 Scovill St, Pavillion B, 3rd Floor, Waterbury, CT 06706-1113 | 2011-02-23 |
| 1285892703 | Allyson Lynn Rovetto | Pediatrics | 95 Scovill St, 3rd Floor, Pavilion B, Waterbury, CT 06706-1113 | 2008-05-30 |
| 1760678965 | Jennifer Voisine Kloze | Pharmacist | 95 Scovill St, Waterbury, CT 06706-1113 | 2007-09-20 |
| 1023139391 | Mary Ann Rourke | Social Worker | 95 Scovill St, 3rd Floor, Waterbury, CT 06706-1113 | 2007-04-03 |
| 1699896902 | Christine Cunningham | Social Worker | 95 Scovill St, 3rd Floor, Waterbury, CT 06706-1113 | 2007-04-03 |
| 1245321553 | Alan Richard Malina | Internal Medicine | 95 Scovill St, Waterbury, CT 06706-1113 | 2006-09-28 |
| 1821001454 | Judith Lynne Moskal-kanz | Nurse Practitioner | 95 Scovill St, 3rd Floor, Waterbury, CT 06706-1113 | 2006-08-14 |
| 1497771208 | Richard Shea | Pediatrics | 95 Scovill St, 3rd Floor, Waterbury, CT 06706-1113 | 2006-07-14 |
| 1568495604 | Shawnette Ann Alston | Internal Medicine | 95 Scovill St, 3rd Floor, Waterbury, CT 06706-1113 | 2006-07-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245750538 | Sameerah Ibtisam Rehmani | Internal Medicine | St Mary's Hospital, 56 Franklin Street, Waterbury, CT 06706 | 2017-06-27 |
| 1417208448 | Sherry L Gatling | Durable Medical Equipment & Medical Supplies | 394 Mill Street, 2nd Flr N, Waterbury, CT 06706 | 2012-10-01 |
| 1144505538 | Amanda Maria Delcavo | Physician Assistant | 50 Franklin Street, Waterbury, CT 06706 | 2011-10-17 |
| 1508097031 | Lauren K Ayr-volta | Clinical Neuropsychologist | 133 Scovill Street, Suite 211, Waterbury, CT 06706 | 2009-07-31 |
| 1538206800 | John Chardavoyne | Psychiatry & Neurology | Waterbury Outpatient Clinic, 95 Scovill Street, Waterbury, CT 06706 | 2007-01-30 |
| 1922111632 | Thomas Owen Genese | Internal Medicine | 56 Franklin Street, St. Mary's Hospital - Dept of Medicine, Waterbury, CT 06706 | 2006-08-16 |
| 1013942465 | Nancy Lou Kline | Nurse Practitioner | 133 Scovill Street-waterbury Va Community Based Clinic, #203, Waterbury, CT 06706 | 2006-07-12 |
| 1013455351 | Denisse Burgos-jimenez | Physician Assistant | 56 Franklin St, Waterbury, CT 06706 | 2017-02-07 |
| 1902255086 | Kaitlyn Jennings | Physician Assistant | 56 Franklin St, Waterbury, CT 06706 | 2016-06-08 |
| 1366823783 | Yamini Sachan | Internal Medicine | 56 Franklin Street, Waterbury, CT 06706 | 2015-06-11 |
| Find all providers in zip 06706 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871650499 | Michael J Rokosky | Pediatrics | 1404 West Main St, Waterbury, CT 06708 | 2007-01-02 |
| 1376505859 | Pediatric Assoc of Conn PC | Pediatrics | 160 Robbins Street, Waterbury, CT 06708 | 2006-04-03 |
| 1154395002 | Linda T Mathew | Pediatrics | 2457 E Main St, Waterbury, CT 06705-2685 | 2006-02-16 |
| 1235131152 | Bidarkote Somanath | Pediatrics | 140 Grandview Ave, Suite No 206, Waterbury, CT 06708-2505 | 2005-08-11 |
| 1336671627 | Eliyahu Akerman | Pediatrics | 179 Roseland Ave, Waterbury, CT 06710-1411 | 2017-03-28 |
| 1144676438 | Elsa Mercedes Martinez | Pediatrics | 80 Phoenix Ave Ste 201, Waterbury, CT 06702-1418 | 2016-05-05 |
| 1033515275 | Chinelo Okwuosa | Pediatrics | 179 Roseland Ave, Waterbury, CT 06710-1411 | 2014-11-17 |
| 1851710008 | Vaishali Bansilal | Pediatrics | 80 Phoenix Ave, Suite 201, Waterbury, CT 06702-1418 | 2014-04-15 |
| 1205178175 | Donald R Swartz | Pediatrics | 93 Pilgrim Park Rd, Suite 6, Waterbury, VT 05676-1727 | 2013-03-19 |
| 1427329416 | Sedat S. Shaban, M.d.,p.c. | Pediatrics | 1389 W Main St, Suite 308, Waterbury, CT 06708-3104 | 2012-01-23 |
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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.