Individual provider Active NPI

Colleen Mary Pietras, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • New Haven, CT
National Provider Identifier
1053574533
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
619412 Issued in CT
Practice address
330 Cedar Street
Boardman 204
New Haven, CT 06510
Phone
(203) 785-5000
Fax
(203) 785-3346
NPI assigned
Jul 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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 619412 CT Primary

Addresses

Primary practice location

330 Cedar Street
Boardman 204
New Haven, CT 06510

Mailing address

330 Cedar Street, Boardman 204
P.O. Box 208041
New Haven, CT 06510
Phone (203) 785-5000

Other practice location 1

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 785-5000

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
619412CTMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

NPI Registry JSON

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

{
    "created_epoch": "1215302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1053574533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 CEDAR STREET, BOARDMAN 204",
            "address_2": "P.O. BOX 208041",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06510",
            "telephone_number": "203-785-5000",
            "fax_number": "203-785-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 CEDAR STREET",
            "address_2": "BOARDMAN 204",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06510",
            "telephone_number": "203-785-5000",
            "fax_number": "203-785-3346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "267 Grant St",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066102805",
            "country_code": "US",
            "telephone_number": "203-785-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIETRAS",
        "first_name": "COLLEEN",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-06",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CT",
            "license": "619412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.