Individual provider Active NPI

Henry Bear Hofbauer, M.D.

  • Internal Medicine Physician
  • Wallingford, CT
National Provider Identifier
1023083193
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15178 Issued in CT
Practice address
850 N Main Street Ext
Building 2, Suite C3
Wallingford, CT 06492-2400
Phone
(203) 265-6522
Fax
(203) 265-5605
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 15178 CT Primary

Addresses

Primary practice location

850 N Main Street Ext
Building 2, Suite C3
Wallingford, CT 06492-2400

Mailing address

850 N Main Street Ext
Building 2, Suite C3
Wallingford, CT 06492-2400
Phone (203) 265-6522

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

LicenseStateTypeSpecialty
15178CTMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1023083193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 N MAIN STREET EXT",
            "address_2": "BUILDING 2, SUITE C3",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922400",
            "telephone_number": "203-265-6522",
            "fax_number": "203-265-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 N MAIN STREET EXT",
            "address_2": "BUILDING 2, SUITE C3",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922400",
            "telephone_number": "203-265-6522",
            "fax_number": "203-265-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFBAUER",
        "first_name": "HENRY",
        "middle_name": "BEAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "15178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.