Vipul Dua, MD, LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

041795 Issued in CT

Legal business name

VIPUL DUA, MD, LLC

Practice address

2800 Tamarack Ave
Suite 106
South Windsor, CT 06074-5539

Phone

(860) 644-5900

Fax

(860) 644-5978

NPI assigned

Nov 11, 2013

Last updated

Nov 11, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vipul Dua, MDNPI 1730103862

Title

Owner

Phone

(860) 644-5900

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT2 enrollments

Enrollment records 2

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vipul Dua, MD

  • Orthopaedic Surgery Physician
  • South Windsor, CT
  • NPI 1730103862
  Medicare reassignment NPD Authorized official
• Shaina Barr

  • Family Nurse Practitioner
  • Bloomfield, CT
  • NPI 1336628718
  Medicare reassignment NPD
• Matthew Charles Dolan, PA-C

  • Physician Assistant
  • Manchester, CT
  • NPI 1770834657
  Medicare reassignment
• Alyssa Olsen

  • Surgical Physician Assistant
  • Manchester, CT
  • NPI 1770933541
  Medicare reassignment
• Alexandr Tarasyuk, PA

  • Physician Assistant
  • South Windsor, CT
  • NPI 1427337385
  Medicare reassignment
• Nicole A. Wizeman, PA-C

  • Surgical Physician Assistant
  • Manchester, CT
  • NPI 1134511595
  Medicare reassignment
• Stephanie Kops

  • Physician Assistant
  • East Longmeadow, MA
  • NPI 1306449608

  CT

  Medicare reassignment

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384128000000",
    "number": "1033548029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 TAMARACK AVE",
            "address_2": "SUITE 106",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060745539",
            "telephone_number": "860-644-5900",
            "fax_number": "860-644-5978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 TAMARACK AVE",
            "address_2": "SUITE 106",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060745539",
            "telephone_number": "860-644-5900",
            "fax_number": "860-644-5978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIPUL DUA, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-11",
        "last_updated": "2013-11-11",
        "status": "A",
        "authorized_official_last_name": "DUA",
        "authorized_official_first_name": "VIPUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-644-5900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CT",
            "license": "041795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730103862",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vasectomy Center of Connecticut, LLC
• Jyothi Vayalakkara, PSY.D.
• Ada Vazquez, LCSW
• H. Gregory Venzie, DPT
• Tyler Veretto, DC
• Ryan Voelker, PHARMD
• John Henry Walker, M.D.
• Bonnie J Walsh, LCSW
• Myles Walsh, LMSW
• Walter Pierog DMD

• Orthopaedic Surgery Physician in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Orthopaedic Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.