CARL W NISSEN (NPI# 1982601530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982601530 |
| Entity Type | Individual |
| Full Name | CARL W NISSEN |
| Credential | MD |
| Practice Address |
195 Eastern Blvd Glastonbury CT 06033-4312 |
| Practice Telephone | 8605277161 |
| Practice Fax Number | 8606528410 |
| Mailing Telephone | 8605277161 |
| Mailing Fax Number | 8606528410 |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2019-03-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 033613 | CT | Allopathic & Osteopathic Physicians |
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
33613 | CT | Allopathic & Osteopathic Physicians |
| N | 207XP3100X |
Orthopaedic Surgery Specialization: Pediatric Orthopaedic Surgery |
033613 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
195 EASTERN BLVD |
| City | GLASTONBURY |
| State | CT |
| Zip Code | 06033-4312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710402656 | Peter Dasilva | Occupational Therapist | 195 Eastern Blvd, Glastonbury, CT 06033-4312 | 2017-08-11 |
| 1245521442 | Steven Vander Naalt | Surgery | 195 Eastern Blvd, Suite 200, Glastonbury, CT 06033-1208 | 2011-04-22 |
| 1619295045 | Hugh E Finch Jr. | Dentist | 195 Eastern Blvd, Suite 202, Glastonbury, CT 06033-1208 | 2010-05-10 |
| 1669701157 | Glastonbury Surgery Center | Clinic/Center | 195 Eastern Blvd, Glastonbury, CT 06033-1208 | 2009-12-14 |
| 1275714123 | Hartford Orthopaedic Plastic & Hand Surgeons, Inc | Durable Medical Equipment & Medical Supplies | 195 Eastern Blvd, Suite 200, Glastonbury, CT 06033-1208 | 2007-11-20 |
| 1417147406 | John Vischio | Internal Medicine | 195 Eastern Blvd, Suite 201, Glastonbury, CT 06033-1208 | 2007-07-26 |
| 1295889970 | Hartford Orthopaedic Plastic & Hand Surgeons, Inc. | Durable Medical Equipment & Medical Supplies | 195 Eastern Blvd, Suite 200, Glastonbury, CT 06033-1208 | 2007-01-22 |
| 1548360126 | Roxanne Dunwoody | Physical Therapist | 195 Eastern Blvd, Suite 200, Glastonbury, CT 06033-1208 | 2006-09-24 |
| 1053410712 | Ralph Peter Stocker | Internal Medicine | 195 Eastern Blvd, # 201, Glastonbury, CT 06033-1208 | 2006-09-21 |
| 1578660155 | Pamela Wilson | Occupational Therapist | 195 Eastern Blvd, Suite 200, Glastonbury, CT 06033-1208 | 2006-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477074649 | Starling Physicians, PC | Durable Medical Equipment & Medical Supplies | 289 Western Blvd, Glastonbury, CT 06033 | 2017-06-28 |
| 1497284897 | D&l Eyecare | Optometrist | 33 Welles Street, Glastonbury, CT 06033 | 2017-06-08 |
| 1730626235 | Half Full Psychiatry LLC | Clinic/Center | 39 New London Tpke Ste 230f, Glastonbury, CT 06033 | 2017-01-23 |
| 1285000117 | Olga A Levkina | Physician Assistant | 2928 Main St Ste 101, Glastonbury, CT 06033 | 2015-08-14 |
| 1619350576 | Ryan Ilg Reichelt | Dentist | 131 New London Tpke Ste 211, Glastonbury, CT 06033 | 2015-07-09 |
| 1316320534 | Devon Banda | Orthopaedic Surgery | The Hand Center, 195 Eastern Blvd, # 200, Glastonbury, CT 06033 | 2015-07-07 |
| 1881073195 | Brittney Stanley | Counselor | 122 Naubuc Ave Ste 104, Glastonbury, CT 06033 | 2015-05-20 |
| 1780071878 | Richard T. Risinger | Dentist | 88 Citizens Drive, Glastonbury, CT 06033 | 2015-04-16 |
| 1639568751 | Carol Jane Gammell | Counselor | 140 Glastonbury Boulevard, Suite 30, Glastonbury, CT 06033 | 2015-01-13 |
| 1407262611 | Prashant Sinha | Dentist | 2874 Main Street, Glastonbury, CT 06033 | 2014-07-08 |
| Find all providers in zip 06033 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396181178 | Alex G. Dukas | Orthopaedic Surgery | 84 Glastonbury Blvd Ste 101, Glastonbury, CT 06033 | 2013-05-20 |
| 1891072104 | Christopher Mccarthy | Orthopaedic Surgery | 195 Eastern Blvd Ste 200, Glastonbury, CT 06033-4353 | 2011-11-15 |
| 1659488815 | Orthopedic Associates of Hartford,pc | Orthopaedic Surgery | 345 Western Blvd, Glastonbury, CT 06033 | 2006-08-24 |
| 1912468141 | Oct Care of Ct, LLC | Orthopaedic Surgery | 2389 Main St, Glastonbury, CT 06033-4617 | 2019-03-29 |
| 1922411628 | Ravi Viradia | Orthopaedic Surgery | 195 Eastern Blvd Ste 200, Glastonbury, CT 06033-4353 | 2014-06-10 |
| 1548680622 | Kyle Grooms | Orthopaedic Surgery | 195 Eastern Blvd Ste 200, Glastonbury, CT 06033-4353 | 2014-04-16 |
| 1952664062 | Arie Gerhard Trouw | Orthopaedic Surgery | 195 Eastern Blvd Ste 200, Glastonbury, CT 06033-4353 | 2012-06-22 |
| 1841428000 | Sean Esmende | Orthopaedic Surgery | 345 Western Blvd, Glastonbury, CT 06033-4380 | 2009-06-26 |
| 1649459785 | Clifford Rios | Orthopaedic Surgery | 345 Western Blvd, Glastonbury, CT 06033-4380 | 2007-10-25 |
| 1851310031 | Orthopaedic Sports Specialists, PC | Orthopaedic Surgery | 84 Glastonbury Blvd, Suite 101, Glastonbury, CT 06033-4468 | 2006-07-19 |
| Find all providers in GLASTONBURY | ||||
| City | GLASTONBURY |
| Zip Code | 06033 |
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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.