STATE OF CONNECTICUT HEALTH CENTER (NPI# 1912165945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912165945 |
| Entity Type | Organization |
| Organization Name | STATE OF CONNECTICUT HEALTH CENTER |
| Other Organization Name | RADIOLOGY HBP GROUP |
| Practice Address |
263 Farmington Ave Radiology Hbp Group Farmington CT 06030-0001 |
| Mailing Address |
263 Farmington Ave Provider Enrollment - Dowling South Farmington CT 06030-2212 |
| Practice Telephone | 8606797503 |
| Practice Fax Number | 8606791610 |
| Mailing Telephone | 8606797503 |
| Mailing Fax Number | 8606791610 |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2012-06-15 |
| Authorized Official Name | DENIS C LAFRENIERE (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8606797503 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | STATE OF CONNECTICUT HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM BLUE CROSS | 500HBX121CT01 | 01 |
| Other Name | Type Code |
|---|---|
| Radiology HBP Group | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497055941 | State of Connecticut Health Center | Health Maintenance Organization | 263 Farmington Ave, Mc 5386, Farmington, CT 06030-5386 | 2010-11-01 |
| 1003074030 | State of Connecticut Health Center | Pathology | 263 Farmington Ave, Laboratory Hbp Group, Farmington, CT 06030-0001 | 2008-05-27 |
| 1811155849 | State of Connecticut Health Center | Obstetrics & Gynecology | 263 Farmington Ave, Ob/gyn Hbp Group, Farmington, CT 06030-0001 | 2008-05-27 |
| 1710156849 | State of Connecticut Health Center | Durable Medical Equipment & Medical Supplies | 850 Bolton Rd, U-85, Storrs Mansfield, CT 06269-9020 | 2008-02-22 |
| 1386821882 | State of Connecticut Health Center | Nurse Practitioner | 263 Farmington Ave, Aprn, Orthopaedics, Farmington, CT 06030-0001 | 2008-01-28 |
| 1669656575 | State of Connecticut Health Center | Pediatrics | 263 Farmington Ave, Pediatric Hematology/oncoloty, Farmington, CT 06030-0001 | 2007-12-27 |
| 1104008408 | State of Connecticut Health Center | Internal Medicine | 263 Farmington Ave, Endrocrinology Associates, Farmington, CT 06030-0001 | 2007-11-29 |
| 1295917599 | State of Connecticut Health Center | Internal Medicine | 263 Farmington Ave, Gastroenterology Associates, Farmington, CT 06030-0001 | 2007-11-29 |
| 1528247541 | State of Connecticut Health Center | Durable Medical Equipment & Medical Supplies | 65 Kane St, West Hartford, CT 06119-2110 | 2007-10-26 |
| Street Address |
263 FARMINGTON AVE RADIOLOGY HBP GROUP |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609879519 | Michael Joseph Giordano | Neurological Surgery | 263 Farmington Ave, Farmington, CT 06030-0001 | 2005-05-24 |
| 1891394995 | Ewa Jaszczolt | Nurse Practitioner | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-10-20 |
| 1295333458 | Brianne Catherine Bischoff | Nurse Practitioner | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-10-10 |
| 1023622073 | Michael John Arciszewski | Perfusionist | 263 Farmington Ave, Farmington, CT 06030-0002 | 2020-09-06 |
| 1073126199 | Esha Bhatt | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06032-1956 | 2020-08-28 |
| 1689286932 | Margaret Darin | Physician Assistant | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-08-18 |
| 1174133656 | Rosa Raquel Huivin | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-08-09 |
| 1336758051 | Sahar Zamani | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06030-0002 | 2020-07-28 |
| 1083222954 | Gabriela Maria Parra | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-07-16 |
| 1780292680 | Bastian Andres Rojas Espinoza | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821617606 | David Wozny | Student in an Organized Health Care Education/Training Program | General Medicine Clinic, Outpatient Pavillion-2 East, 263 Farmington Ave, Farmington, CT 06030 | 2020-04-13 |
| 1508495185 | Zachary Boivin | Student in an Organized Health Care Education/Training Program | Emergency Medicine Office, 263 Farmington Ave, Farmington, CT 06030 | 2020-04-06 |
| 1063903730 | Agura Afiari | Student in an Organized Health Care Education/Training Program | Uconn School of Medicine, 263 Farmington Avenue, Farmington, CT 06030 | 2018-05-29 |
| 1750879474 | Areeba Siddiqui | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue Mc1921, Farmington, CT 06030 | 2018-04-27 |
| 1508362013 | Arya Saniee I | Student in an Organized Health Care Education/Training Program | 264 Farmington Ave, Farmington, CT 06030 | 2018-04-03 |
| 1679828594 | Randall Morera | Student in an Organized Health Care Education/Training Program | 262 Farmington Ave, Farmington, CT 06030 | 2012-07-17 |
| 1750644365 | Ugonna Ijeoma | Student in an Organized Health Care Education/Training Program | 260 Farmington Ave, Farmington, CT 06030 | 2012-06-19 |
| 1407018419 | Julia Marie Toto | Plastic Surgery | University Physicians, 263 Farmington Avenue, Farmington, CT 06030 | 2008-06-30 |
| 1851456495 | Jeffrey Gross | Anesthesiology | 263 Farmington Avenue, Mc-2015, John Dempsey Hospital, Farmington, CT 06030 | 2006-12-26 |
| 1649225269 | Julian Nieves | Internal Medicine | 263 Famrington Avenue, Farmington, CT 06030 | 2006-05-23 |
| Find all providers in zip 06030 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275987802 | Farmington Imaging Center, LLC | Radiology | 399 Farmington Ave Lowr 1, Farmington, CT 06032-1937 | 2016-04-20 |
| 1538521679 | Focus Point Diagnostics LLC | Radiology | 23337 Orchard Lake Rd, Farmington, MI 48336-3238 | 2016-03-28 |
| 1619103306 | Christopher Michael Garcia | Radiology | 23 Hidden Oak Dr, Farmington, CT 06032-2735 | 2009-06-08 |
| 1992715122 | Kenneth L Miller | Radiology | 1101 W Liberty, Parkland Health Center Dept of Radiology, Farmington, MO 63640 | 2006-08-09 |
| 1497761795 | Medical Diagnostic Services Ltd | Radiology | 657a W Maple, Farmington, NM 87401 | 2006-07-31 |
| 1336182393 | Lynne F Bliss | Radiology | 801 W. Maple, Farmington, NM 87401 | 2006-06-14 |
| 1073507596 | Joseph B Alley | Radiology | 111 Farmington Health Commons, Farmington, ME 04938-6144 | 2005-09-12 |
| 1841284783 | John R Webster | Radiology | 801 W Maple Street, Farmington, NM 87401 | 2005-09-07 |
| 1144222779 | David Ray Dedrickson | Radiology | 1433 N 1075 W, Ste 104, Farmington, UT 84025-2746 | 2005-08-12 |
| 1629075684 | Steven Brent Lee | Radiology | 1433 N 1075 W Ste 104, Farmington, UT 84025-2746 | 2005-07-06 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 06030 |
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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.