CONNECTICUT SURGICAL GROUP, PC (NPI# 1972586675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972586675 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT SURGICAL GROUP, PC |
| Practice Address |
98 Main St Suite 303 Southington CT 06489-2500 |
| Mailing Address |
17 Talcott Notch Rd Farmington CT 06032-1818 |
| Practice Telephone | 2032381241 |
| Practice Fax Number | 8606860791 |
| Mailing Telephone | 8605242626 |
| Mailing Fax Number | 8606775029 |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2010-10-21 |
| Authorized Official Name | DOUGLAS C MCKELL (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Telephone | 8605244326 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004139350 | 05 | |
| CT | ANTHEM BCBS | 50CONNSURCT01 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700940509 | Connecticut Surgical Group, PC | Plastic Surgery | 100 Hazard Avenue, Suite 206, Enfield, CT 06082-5447 | 2006-12-19 |
| 1922170786 | Connecticut Surgical Group, PC | Durable Medical Equipment & Medical Supplies | 680 South Main Street, Lower Level 2, Cheshire, CT 06410-3190 | 2006-11-15 |
| 1518940204 | Connecticut Surgical Group, PC | Surgery | 120 Simsbury Rd, Avon, CT 06001-3735 | 2005-11-28 |
| 1952589434 | Connecticut Surgical Group, PC | Podiatrist | 29 Haynes St, Manchester, CT 06040-4139 | 2008-02-06 |
| 1023291622 | Connecticut Surgical Group, PC | Plastic Surgery | 455 Lewis Ave, Suite 210, Meriden, CT 06451-2121 | 2007-12-06 |
| 1104988609 | Connecticut Surgical Group, PC | Plastic Surgery | 399 Farmington Ave, Suite 200, Farmington, CT 06032-1943 | 2006-12-14 |
| 1639231046 | Connecticut Surgical Group, PC | Plastic Surgery | 1084 Cromwell Ave, Rocky Hill, CT 06067-3445 | 2006-12-14 |
| 1467514893 | Connecticut Surgical Group, PC | Plastic Surgery | 2800 Tamarack Rd, South Windsor, CT 06074-5539 | 2006-12-14 |
| 1164406518 | Connecticut Surgical Group, PC | Urology | 330 Western Blvd, Glastonbury, CT 06033-1236 | 2005-11-30 |
| 1073597415 | Connecticut Surgical Group, PC | Surgery | 1 Liberty Sq, New Britain, CT 06051-2636 | 2005-11-30 |
| Street Address |
98 MAIN ST SUITE 303 |
| City | SOUTHINGTON |
| State | CT |
| Zip Code | 06489-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215934658 | Wilner Samson | Internal Medicine | 98 Main St, Southington, CT 06489-2500 | 2005-06-30 |
| 1619460565 | Alysia Rodriguez | Social Worker | 98 Main St, Southington, CT 06489-2500 | 2018-06-14 |
| 1477926459 | Core Principles | Specialist | 98 Main St, Southington, CT 06489-2500 | 2015-11-12 |
| 1407233547 | Sana Idrees | Internal Medicine | 98 Main St, Southington, CT 06489 | 2015-04-27 |
| 1710327416 | Apeksha Vachhani | Family Medicine | 98 Main St, Hartford Healthcare Medical Group, Southington, CT 06489-2500 | 2013-06-27 |
| 1255560124 | Eleonore Roesch | Internal Medicine | 98 Main St, Suite 301, Southington, CT 06489-2500 | 2009-07-13 |
| 1699950014 | Orthopedic Physical Therapy LLC | Physical Therapist | 98 Main St, Suite 202, Southington, CT 06489-2500 | 2008-01-03 |
| 1821292780 | Michael Daley | Physical Therapist | 98 Main St, Suite 202, Southington, CT 06489-2500 | 2007-06-13 |
| 1548271463 | Michael Anthony Sposato | Physician Assistant | 98 Main St, Midstate Medical Group, Southington, CT 06489-2500 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467087783 | Shankar Panwar | Counselor | K 11, 1783 Meriden Waterbury Tpke, Southington, CT 06489 | 2020-03-06 |
| 1235771056 | Kathleen Rebecca Mckinney | Music Therapist | 196 Queen St., Southington, CT 06489 | 2019-10-14 |
| 1336700103 | Julie Amanda Nichols | Behavioral Analyst | 1842 Meriden-waterbury Turnpike, Southington, CT 06489 | 2019-06-24 |
| 1396238960 | Kriston Ronalter | Physician Assistant | 775 Queen Street, Southington, CT 06489 | 2018-06-08 |
| 1366933582 | Cj's Counseling, LLC | Counselor | 17 Meriden Ave Ste 1a, Southington, CT 06489 | 2018-05-23 |
| 1104329887 | Koby Douglas Fowler | Chiropractor | 1095 West St Unit 1, Southington, CT 06489 | 2018-03-09 |
| 1447763131 | Samreen, LLC | Clinic/Center | 775 Queen St, Suite 2, Southington, CT 06489 | 2017-11-16 |
| 1902320724 | Michael Petit | Physical Therapist | 98 Main Street, 202, Southington, CT 06489 | 2017-08-02 |
| 1457712127 | Leslie Mclaughlin | Speech-Language Pathologist | 400 Flanders Rd, Southington, CT 06489 | 2016-03-09 |
| 1306219159 | Breanne Schnepf-hanbury | Counselor | 26 N Main St Ste 2b, Southington, CT 06489 | 2015-11-02 |
| Find all providers in zip 06489 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164659165 | Rite Aid of Connecticut, Inc. | Durable Medical Equipment & Medical Supplies | 500 Queen Street, Southington, CT 06489-1801 | 2009-06-17 |
| 1457509457 | Connecticut Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2100 Killingly Commons, Southington, CT 06489 | 2008-09-03 |
| 1770659401 | Grove Hill Medical Center PC | Durable Medical Equipment & Medical Supplies | 360 North Main Street, Grove Hill Medical Center, Southington, CT 06489 | 2006-11-27 |
| 1740385582 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 724 Queens St, Edwards Plz, Southington, CT 06489-1505 | 2006-09-14 |
| 1184730814 | Dca Inc | Durable Medical Equipment & Medical Supplies | 609 N Main St, Southington, CT 06489-2051 | 2006-08-23 |
| 1255358545 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 235 Queen St, Southington, CT 06489-1915 | 2006-07-16 |
| 1396268355 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 167 Main St, Southington, CT 06489-2505 | 2017-07-21 |
| 1184047854 | Drs Welch & Riddle | Durable Medical Equipment & Medical Supplies | 231 Main St, Southington, CT 06489-2507 | 2014-01-30 |
| 1972607877 | Connecticut Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 326 Main St, Southington, CT 06489-2508 | 2006-09-12 |
| 1740399120 | Rite Aid of Connecticut Inc | Durable Medical Equipment & Medical Supplies | 167 Main Street, Southington, CT 06489-2505 | 2006-08-30 |
| Find all providers in SOUTHINGTON | ||||
| City | SOUTHINGTON |
| Zip Code | 06489 |
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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.