Active NPI
David Baird Lobozzo, MD
- Psychiatry Physician
- Groton, CT
National Provider Identifier
1063405132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD13263
- Practice address
- 1 Wahoo Ave
Groton, CT 06349-2324 - Phone
- (860) 694-4966
- NPI assigned
- Aug 24, 2005
- Last updated
- Jan 6, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD13263 | ME | Primary |
Addresses
Primary practice location
1 Wahoo Ave
Groton, CT 06349-2324
Mailing address
144 Lower Blvd
New London, CT 06320-4333
Phone (207) 440-9827
Other practice location 1
900 Washington Rd
West Point, NY 10996-1109
Phone (845) 938-3441
Other practice location 2
477 Congress St
Suite 420
Portland, ME 04101-3427
Phone (207) 773-1290
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 124500000 | Other | ME | MAINE CARE |
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 |
|---|---|---|---|
| MD13263 | ME | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-County Mental Health Services | Past | Accepting new patients | |
| Spurwink Services Incorporated | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Portland, ME
- NPI 1760507297
-
- Mental Health Counselor
- Lewiston, ME
- NPI 1215979158
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736121600000",
"number": "1063405132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 LOWER BLVD",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063204333",
"telephone_number": "207-440-9827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 WAHOO AVE",
"city": "GROTON",
"state": "CT",
"postal_code": "063492324",
"telephone_number": "860-694-4966"
}
],
"practiceLocations": [
{
"address_1": "900 Washington Rd",
"address_purpose": "LOCATION",
"city": "West Point",
"state": "NY",
"postal_code": "109961109",
"country_code": "US",
"telephone_number": "845-938-3441",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "477 Congress St",
"address_2": "Suite 420",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "ME",
"postal_code": "041013427",
"country_code": "US",
"telephone_number": "207-773-1290",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOBOZZO",
"first_name": "DAVID",
"middle_name": "BAIRD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2025-01-06",
"certification_date": "2025-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ME",
"license": "MD13263",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAINE CARE",
"identifier": "124500000",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Groton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.