CONNECTICUT SURGICAL GROUP, PC (NPI# 1952589434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952589434 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT SURGICAL GROUP, PC |
| Practice Address |
29 Haynes St Manchester CT 06040-4139 |
| Mailing Address |
17 Talcott Notch Rd Farmington CT 06032-1818 |
| Practice Telephone | 8605470616 |
| Practice Fax Number | 8605242655 |
| Mailing Telephone | 8605470616 |
| Mailing Fax Number | 8605242655 |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2010-08-11 |
| Authorized Official Name | MR. DOUGLAS C. MCKELL (CAO) |
| Authorized Official Telephone | 8605244326 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 9781188 | 05 | |
| NY | 01926310 | 05 | |
| CT | 004201034 | 05 | |
| CT | 004139350 | 05 | |
| CT | 004169711 | 05 | |
| CT | ANTHEM | 50CONNSURG01 | 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 |
| 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 |
29 HAYNES ST |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06040-4139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861465635 | Reginald Winfield Raynor IIi | Surgery | 29 Haynes St, Suite B, Manchester, CT 06040-4139 | 2006-02-10 |
| 1427675354 | Orthopedic Associates of Hartford,pc | Durable Medical Equipment & Medical Supplies | 29 Haynes St, Manchester, CT 06040-4139 | 2020-06-26 |
| 1255858593 | Alexander W Bernard | Physical Therapist | 29 Haynes St, Manchester, CT 06040-4139 | 2017-08-28 |
| 1659799823 | Brian Wirtalla | Physical Therapist | 29 Haynes St, Suite A, Manchester, CT 06040-4139 | 2014-04-03 |
| 1033461454 | Hartford Healthcare Medical Group, Inc | Podiatrist | 29 Haynes St, Manchester, CT 06040-4139 | 2012-10-09 |
| 1386924264 | Hartford Clinical Associates, PC | Podiatrist | 29 Haynes St, Manchester, CT 06040-4139 | 2011-08-23 |
| 1174801682 | Jeffrey M Ranaudo | Surgery | 29 Haynes St, Unit D, Manchester, CT 06040-4139 | 2011-08-01 |
| 1619126190 | Monika M Rejnin | Physician Assistant | 29 Haynes St, Suite D, Manchester, CT 06040-4139 | 2008-09-09 |
| 1871634279 | Connecticut Center for Orthopedic Surgery, LLC | Orthopaedic Surgery | 29 Haynes St, Manchester, CT 06040-4139 | 2007-02-09 |
| 1548224512 | James T Mazzara | Orthopaedic Surgery | 29 Haynes St, Manchester, CT 06040-4139 | 2006-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710501333 | Mackenzie Lawler | Social Worker | 200 W. Center Street, Suite C-2-6, Manchester, CT 06040 | 2020-05-29 |
| 1386288009 | Monica Diaz | Social Worker | 117 East Center Street, Suite A1, Manchester, CT 06040 | 2019-11-06 |
| 1346881596 | Sheryl Andrine Henry | Technician | 185 Pine Street, Apt 014, Manchester, CT 06040 | 2019-09-30 |
| 1811550304 | Edward Wahn Lee | Student in an Organized Health Care Education/Training Program | 130 Hartford Road, Manchester, CT 06040 | 2019-04-19 |
| 1538689534 | Bernard Ashirifie | Counselor | 869 Main Street, Apt 3, Manchester, CT 06040 | 2017-06-21 |
| 1497275697 | Justin David Chung | Dentist | 483 Middle Tpke W Ste 209, Manchester, CT 06040 | 2017-06-20 |
| 1114473436 | Amanda Edgar | Counselor | 469 Center Street, Manchester, CT 06040 | 2016-08-28 |
| 1760831366 | Samantha Micael | Marriage & Family Therapist | 200 West Center Street, Suite C-2-6, Manchester, CT 06040 | 2016-06-06 |
| 1962856179 | Odelia Brew | Nurse Practitioner | 256 Hackmatack Street, Manchester, CT 06040 | 2016-04-14 |
| 1306217765 | Stephen R Machattie | Social Worker | 843 Main St Ste 11, Manchester, CT 06040 | 2015-10-12 |
| Find all providers in zip 06040 | ||||
| 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 |
|---|---|---|---|---|
| 1619494473 | Tlc Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 1621 S Highway 421 Ste 2, Manchester, KY 40962-7514 | 2017-08-23 |
| 1447776240 | Manchester Health Supplies | Durable Medical Equipment & Medical Supplies | 373 S Willow Street, #328, Manchester, NH 03103 | 2017-08-14 |
| 1477008480 | Manchester Down Home Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 500 Richmond Rd, Manchester, KY 40962-1294 | 2016-08-19 |
| 1487009387 | Rx Discount Pharmacy of Hazard Inc | Durable Medical Equipment & Medical Supplies | 509 Memorial Dr Ste 1, Manchester, KY 40962-6196 | 2016-04-28 |
| 1154736015 | Claim Path New Hampshire, LLC | Durable Medical Equipment & Medical Supplies | 816 Elm St # 259, Manchester, NH 03101-2105 | 2014-06-30 |
| 1861816654 | James Hradecky | Durable Medical Equipment & Medical Supplies | 816 Elm St # 248, Manchester, NH 03101-2105 | 2014-02-13 |
| 1134559768 | Manchester Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 359 Old Us Highway 421, Manchester, KY 40962-7538 | 2013-11-18 |
| 1528408705 | Midwest Practice Solutions Stl LLC | Durable Medical Equipment & Medical Supplies | 14585 Manchester Rd, Manchester, MO 63011-3963 | 2013-07-02 |
| 1982964672 | Billing Advocates, LLC | Durable Medical Equipment & Medical Supplies | 816 Elm St # 206, Manchester, NH 03101-2105 | 2012-05-29 |
| 1336430842 | Pennsylvania Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4035 N George Street Ext, Manchester, PA 17345-9203 | 2011-05-02 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 06040 |
Please comment or provide details below to improve the information on CONNECTICUT SURGICAL GROUP, PC.
| 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.