Active NPI
Alan Michael Spagnola, M.D.
- Internal Medicine Physician
- Essex, CT
National Provider Identifier
1023032208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 019375
- Practice address
- 10 Wildwood Medical Ctr
Essex, CT 06426-1154 - Phone
- (860) 767-0145
- Fax
- (860) 767-0021
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 019375 | CT | Primary |
| Rheumatology Physician | 207RR0500X | 019375 | CT |
Addresses
Primary practice location
10 Wildwood Medical Ctr
Essex, CT 06426-1154
Mailing address
10 Wildwood Medical Ctr
Essex, CT 06426-1154
Phone (860) 767-0145
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001193754 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019375 | CT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS. Baldwin, Hornbake and Spagnola PC | Internal Medicine | Past | Accepting new patients |
| Alan M Spagnola, MD, PC | Internal Medicine | Past | Accepting new patients |
| Prohealth Physicians PC | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Essex, CT
- NPI 1194958918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338336000000",
"number": "1023032208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 WILDWOOD MEDICAL CTR",
"city": "ESSEX",
"state": "CT",
"postal_code": "064261154",
"telephone_number": "860-767-0145",
"fax_number": "860-767-0021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 WILDWOOD MEDICAL CTR",
"city": "ESSEX",
"state": "CT",
"postal_code": "064261154",
"telephone_number": "860-767-0145",
"fax_number": "860-767-0021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPAGNOLA",
"first_name": "ALAN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2012-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "019375",
"primary": true
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "CT",
"license": "019375",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001193754",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Essex, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.