Individual provider Active NPI

Constantine Michael Poulos, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Danbury, CT
National Provider Identifier
1043742356
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
76785 Issued in CT
Practice address
24 Hospital Ave
Danbury, CT 06810-6099
Phone
(203) 554-3885
NPI assigned
Mar 28, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 76785 CT Primary

Addresses

Primary practice location

24 Hospital Ave
Danbury, CT 06810-6099

Mailing address

24 Hospital Ave
Danbury, CT 06810-6099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240708001870 CT Practitioner - Thoracic Surgery 4385915602 Reassigns benefits to 1 organization
I20251125000068 NY Practitioner - Thoracic SurgeryPractitioner - General Surgery 4385915602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

7 Germantown Rd
Danbury, CT 06810-5000
Phone (203) 739-7761

Hospital & facility affiliations

  • Danbury Hospital Hospital, Danbury, CT, CCN 070033
  • Norwalk Hospital Hospital, Norwalk, CT, CCN 070034

Merit-based Incentive Payment System (MIPS)

Final score
74.75 of 100Reported as group
Quality
67.52
Promoting interoperability
95
Improvement activities
20
Cost
74.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. CurrentSince Jul 9, 2024 Accepting new patients
Nuvance Health Medical Practice PC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Sep 18, 2025 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

7 Germantown Rd
Danbury, CT 06810
Phone (203) 739-7761

45 Reade Pl
Fl 3
Poughkeepsie, NY 12601
Phone (845) 483-6920

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1043742356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106099",
            "telephone_number": "203-554-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULOS",
        "first_name": "CONSTANTINE",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CT",
            "license": "76785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.