BLUEGRASS MEDICINE & NEPHROLOGY, LLC (NPI# 1962654178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962654178 |
| Entity Type | Organization |
| Organization Name | BLUEGRASS MEDICINE & NEPHROLOGY, LLC |
| Practice Address |
455 Lewis Ave Suite 214 Meriden CT 06451-2121 |
| Practice Telephone | 2032376700 |
| Mailing Telephone | 2032376700 |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2009-06-29 |
| Authorized Official Name | IRFAN SAEED CHUGHTAI (SOLE PROPRIETOR) |
| Authorized Official Telephone | 2032376700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
039668 | CT | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | BLUEGRASS MEDICINE & NEPHROLOGY, LLC | 789 Eastern Bypass, Suite 16, Richmond, KY 40475 |
| Street Address |
455 LEWIS AVE SUITE 214 |
| City | MERIDEN |
| State | CT |
| Zip Code | 06451-2121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710986898 | David M Sack | Internal Medicine | 455 Lewis Ave, Suite 105, Meriden, CT 06451-2121 | 2005-07-20 |
| 1740601665 | Katelyn Spence | Nurse Practitioner | 455 Lewis Ave, Suite 220, Meriden, CT 06451-2121 | 2013-12-18 |
| 1336491752 | Hartford Healthcare Medical Group, Inc | Urology | 455 Lewis Ave, Ste. 210, Meriden, CT 06451-2121 | 2012-10-09 |
| 1316227291 | Hartford Clinical Associates, PC | Urology | 455 Lewis Ave, Suite 210, Meriden, CT 06451-2121 | 2011-08-23 |
| 1265669089 | Madhavi Bhoomagoud | Internal Medicine | 455 Lewis Ave, Suite 105, Meriden, CT 06451-2121 | 2009-06-18 |
| 1982839247 | Connecticut Nephrology Associates LLC | Internal Medicine | 455 Lewis Ave, Suite 214, Meriden, CT 06451-2121 | 2009-05-15 |
| 1639316177 | Rafal Barczak | Surgery | 455 Lewis Ave, Meriden, CT 06451-2121 | 2009-01-20 |
| 1598919045 | Paul Pyo | Urology | 455 Lewis Ave, Suite 210, Meriden, CT 06451-2121 | 2008-11-11 |
| 1366692691 | Aly Hemdan Abdalla | Internal Medicine | 455 Lewis Ave, Suite 206, Meriden, CT 06451-2121 | 2008-09-23 |
| 1164606372 | Kenneth M Schwartz | Surgery | 455 Lewis Ave, Suite 208, Meriden, CT 06451-2121 | 2007-12-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225490055 | Great Hills LLC | Pharmacy | 152 Colony St Unit A, Meriden, CT 06451 | 2016-03-22 |
| 1659695344 | Dr. Bertolli Od & Associates LLC | Optometrist | 470 Lewis Avenue, C/o Sears Optical, Meriden, CT 06451 | 2010-03-24 |
| 1205086733 | Michelle Lavallee Dagostine | Psychiatry & Neurology | 455 Lewis Ave., Suite 221, Meriden, CT 06451 | 2008-09-20 |
| 1538212857 | Meriden Surgical Supply Inc | Prosthetic/Orthotic Supplier | 170 West Main Street, Meriden, CT 06451 | 2007-01-19 |
| 1922036920 | Lisa M Marvin Smith | Nurse Practitioner | 26 Womens Way, Meriden, CT 06451 | 2006-06-29 |
| 1831683523 | Trisha Kowalski | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-06-18 |
| 1093203424 | Ryan Wessels | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-05-01 |
| 1235599333 | Mcm Dental, LLC | Dentist | 74 Main Street, Lakewood, CT 06451 | 2016-03-02 |
| 1215270533 | Rouzbeh Fateh | Psychiatry & Neurology | 435 Lewis Ave, Meriden, CT 06451 | 2013-04-04 |
| 1790035186 | Jona Lesage Maloney | Music Therapist | 122 Windsor Ave, 2nd Floor, Meriden, CT 06451 | 2012-09-13 |
| Find all providers in zip 06451 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
| 1992264006 | Ground Force Medicine LLC | Clinic/Center | 80 Shunpike Rd Unit 101, Cromwell, CT 06416-4402 | 2019-03-18 |
| 1275012148 | Guilford Holistic Health Practitioners, LLC | Clinic/Center | 5 Durham Rd Ste B6, Guilford, CT 06437 | 2018-08-10 |
| 1457866485 | New England Center for Health and Nutrition LLC | Clinic/Center | 39 Nott Hwy, Ashford, CT 06278-1341 | 2017-12-13 |
| 1154752129 | Chiropractic Care, LLC | Clinic/Center | 1162 Dixwell Ave, Suite A, Hamden, CT 06514-4732 | 2013-12-02 |
| 1225370422 | The Greenwich Medical Skincare and Laser Spa | Clinic/Center | 1345 E. Putnam Ave, The Greenwich Medical Skincare and Laser Spa, Old Greenwich, CT 06870 | 2013-03-26 |
| 1467750356 | Advanced 6 Health Care LLC | Clinic/Center | 34 Dale Rd Ste 103, Avon, CT 06001-3659 | 2011-03-02 |
| 1770887739 | Sleep Healthcare of Ct LLC | Clinic/Center | 1305 Post Rd., Suite 305, Fairfield, CT 06824 | 2011-01-06 |
| 1952429011 | Danna L Jennings | Clinic/Center | 60 Temple St Ste 8b, New Haven, CT 06510-2716 | 2007-03-27 |
| 1477912988 | Pediatric Ear, Nose & Throat Associates, P.C. | Clinic/Center | 65 Lasalle Rd, West Hartford, CT 06107-2374 | 2016-02-12 |
| 1407260516 | New Directions In Medicine, Inc | Clinic/Center | 199 Main St, Suite 1, Salisbury, CT 06068-1804 | 2014-06-17 |
| 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.