SHORELINE SURGICAL ASSOC. P.C. (NPI# 1699893925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699893925 |
| Entity Type | Organization |
| Organization Name | SHORELINE SURGICAL ASSOC. P.C. |
| Practice Address |
400 Saybrook Rd Suite 110 Middletown CT 06457 |
| Practice Telephone | 8603479167 |
| Practice Fax Number | 8603471630 |
| Mailing Telephone | 8603479167 |
| Mailing Fax Number | 8603471630 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2016-05-02 |
| Authorized Official Name | JOSEPH A COATTI (PRESIDENT) |
| Authorized Official Telephone | 8603479167 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004394524 | 05 | |
| CT | RAILROAD-MEDICARE | CA8575 | 01 |
| Street Address |
400 SAYBROOK RD SUITE 110 |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235110354 | Roger D Luskind | Ophthalmology | 400 Saybrook Rd, Suite 100, Middletown, CT 06457-4773 | 2005-11-07 |
| 1386115806 | Rachel Mazzola | Nurse Practitioner | 400 Saybrook Rd, Middletown, CT 06457-4773 | 2018-12-10 |
| 1801137039 | Courtney Rose Whittle | Physician Assistant | 400 Saybrook Rd, Suite 205, Middletown, CT 06457-4773 | 2013-03-13 |
| 1053663112 | Tamscot Yap | Optometrist | 400 Saybrook Rd, Middletown, CT 06457-4773 | 2012-10-12 |
| 1972868198 | Pranav Kapoor | Family Medicine | 400 Saybrook Rd, Suite 205, Middletown, CT 06457-4773 | 2012-07-13 |
| 1760790968 | Mary Suzanne Izzo | Dietitian, Registered | 400 Saybrook Rd, Suite 110, Middletown, CT 06457-4773 | 2010-09-22 |
| 1356576128 | Kari Edelson | Pediatrics | 400 Saybrook Rd, Suite 206, Middletown, CT 06457-4773 | 2009-05-22 |
| 1770721862 | Barbara L Hughes | Counselor | 400 Saybrook Rd, Middletown, CT 06457-4773 | 2009-01-27 |
| 1801083498 | Kittie Lee Spedding | Dietitian, Registered | 400 Saybrook Rd, Suite 110, Middletown, CT 06457-4773 | 2007-09-27 |
| 1437375920 | Elizabeth Joslow Archambault | Dietitian, Registered | 400 Saybrook Rd, Shoreline Surgical Associates Suite 110, Middletown, CT 06457 | 2007-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770503633 | Robert G. Kulak | Surgery | 236 Crystal Run Road, Middletown, NY 10941 | 2006-07-20 |
| 1760456396 | Wayne Mark Weiss | Surgery | 384 Crystal Run Rd, Suite 201, Middletown, NY 10941-4013 | 2006-02-13 |
| 1275523409 | Daniel A Butler | Surgery | 4040 Roosevelt Blvd, Middletown, OH 45044-6619 | 2005-10-27 |
| 1114398203 | Db Md Wcc LLC | Surgery | 1 Medical Center Dr, Middletown, OH 45005-2584 | 2015-10-14 |
| 1255746590 | Diamond State Surgical Associates,llc | Surgery | 124 Sleepy Hollow Dr, Suite 201, Middletown, DE 19709-5838 | 2014-06-25 |
| 1477896553 | Bo-kyu Kim | Surgery | 4040 Roosevelt Blvd, Middletown, OH 45044-6619 | 2013-03-27 |
| 1508139379 | Yuriy Zhurov | Surgery | 95 Crystal Run Rd, Middletown, NY 10941-7001 | 2012-02-09 |
| 1861797193 | Moaz Waleed Abulfaraj | Surgery | 95 Crystal Run Rd, Middletown, NY 10941-7001 | 2011-01-18 |
| 1083932719 | James Michael Parker | Surgery | 520 Saybrook Rd, Suite 100, Middletown, CT 06457-4700 | 2010-05-05 |
| 1952628778 | Heather Hartman Adkins | Surgery | 4040 Roosevelt Blvd, Middletown, OH 45044-6619 | 2010-05-04 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
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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.