CONNECTICUT SURGICAL GROUP, PC (NPI# 1922170786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922170786 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT SURGICAL GROUP, PC |
| Practice Address |
680 South Main Street Lower Level 2 Cheshire CT 06410-3190 |
| Mailing Address |
17 Talcott Notch Rd Farmington CT 06032-1818 |
| Practice Telephone | 2032381241 |
| Practice Fax Number | 2036860791 |
| Mailing Telephone | 8605242626 |
| Mailing Fax Number | 8606775029 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2011-03-02 |
| 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 | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers | ||
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004139350 | 05 | |
| CT | ANTHEM BCBS | 50CONNSURCT01 | 01 |
| CT | OXFORD | G384943 | 01 |
| MA | 9781188 | 05 | |
| CT | AETNA | 87090 | 01 |
| CT | CSMS-IPA | 0000S02059 | 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 |
| 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 |
| 1053395400 | Connecticut Surgical Group, PC | Podiatrist | 85 Seymour St, Ste 409, Hartford, CT 06106 | 2005-11-30 |
| Street Address |
680 SOUTH MAIN STREET LOWER LEVEL 2 |
| City | CHESHIRE |
| State | CT |
| Zip Code | 06410-3190 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549252 | Piece To Peace, LLC | Social Worker | 609 West Johnson Avenue, Third Floor, Cheshire, CT 06410 | 2020-02-05 |
| 1023678869 | Suzanne Meyer-farrell | Counselor | 673 South Avenue, Cheshire, CT 06410 | 2019-06-14 |
| 1508347162 | Bright Futures Wellness Center, LLC | Nurse Practitioner | 422-426 Highland Avenue, Cheshire, CT 06410 | 2018-08-22 |
| 1528558525 | Stephen Lynam | Specialist/Technologist | 300 Wiese Rd, Cheshire, CT 06410 | 2018-05-15 |
| 1205358934 | Jayme Lynn Tapp | Physical Therapist | 150 Cook Hill Road, Cheshire, CT 06410 | 2017-07-14 |
| 1366810152 | Lauren K Johnson | Counselor | 609 W Johnson Ave Unit 310, Cheshire, CT 06410 | 2015-09-10 |
| 1225423924 | Christian Daniel Ward | Internal Medicine | 366 S Main St Ste 2, Cheshire, CT 06410 | 2015-03-31 |
| 1750795647 | James W. Pier, Ph.d., LLC | Clinical Neuropsychologist | 700 West Johnson Ave., Suite #310, Cheshire, CT 06410 | 2014-06-18 |
| 1619398427 | Joanna Garfinkle | Psychologist | 1095 South Main Street, Cheshire, CT 06410 | 2013-12-20 |
| 1649511437 | Heather R Laselle | Social Worker | 176 Robin Ln, Cheshire, CT 06410 | 2013-03-05 |
| Find all providers in zip 06410 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083859649 | Thomas V Divinagracia | Radiology | 85 Seymour St., Suite 409, Hartford, CT 06106 | 2008-12-11 |
| 1336176270 | Daniel Jay Kase | Radiology | 57 Commercial Blvd, Torrington, CT 06790-3097 | 2006-06-27 |
| 1184686933 | Bryan Thomas Suchecki | Radiology | 65 Douglas Rd, Glastonbury, CT 06033-2219 | 2006-04-05 |
| 1669458766 | Domenic A. Zambuto | Radiology | 110 Albany Tpke, 209, Canton, CT 06019-2547 | 2005-12-20 |
| 1417933961 | Fernando F. Illescas | Radiology | 701 Cottage Grove Rd Ste E110, Bloomfield, CT 06002-3085 | 2005-12-16 |
| 1700494887 | Advanced Radiology Partners LLC | Radiology | 15 Corporate Dr, Trumbull, CT 06611-1351 | 2020-07-15 |
| 1417574708 | K&h Medical Ct Pllc | Radiology | 160 West Street, Builing 1 Suite 7, Cromwell, CT 06416 | 2020-07-02 |
| 1174168926 | Vinay Madan, Md, LLC | Radiology | 35 Danbury Rd, Wilton, CT 06897-4428 | 2019-11-14 |
| 1639739634 | Vein Centers, LLC | Radiology | 23 Cedar St, New Britain, CT 06052-1301 | 2019-06-20 |
| 1417361627 | James Gardner | Radiology | 20 York St, New Haven, CT 06510-3220 | 2014-06-16 |
| 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.