Organization Active NPI

Allergy Associates of Waterbury, P.C.

  • Allergy & Immunology Physician
  • Waterbury, CT
National Provider Identifier
1073602959
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
016561 Issued in CT
Legal business name
ALLERGY ASSOCIATES OF WATERBURY, P.C.
Practice address
475 Chase Pkwy
Waterbury, CT 06708-3339
Phone
(203) 755-4200
NPI assigned
Oct 11, 2006
Last updated
Mar 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Authorized official

Name
Dr. Melvyn Ranish, M.D.NPI 1326048240
Title
President
Phone
(203) 755-4200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 016561 CT Primary

Addresses

Primary practice location

475 Chase Pkwy
Waterbury, CT 06708-3339

Mailing address

475 Chase Pkwy
Waterbury, CT 06708-3339
Phone (203) 755-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080215000358 CT Part B Supplier - Clinic/Group Practice 2062595952 Receives reassigned benefits from 2 practitioners
Practice locations: Oxford, CT; Waterbury, CT

National Provider Directory

National Provider Directory

Locations

105 Oxford Rd
Oxford, CT 06478
Phone (203) 888-5999

475 Chase Pkwy
Waterbury, CT 06708
Phone (203) 755-4200

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1073602959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 CHASE PKWY",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083339",
            "telephone_number": "203-755-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 CHASE PKWY",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083339",
            "telephone_number": "203-755-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY ASSOCIATES OF WATERBURY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "RANISH",
        "authorized_official_first_name": "MELVYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-755-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CT",
            "license": "016561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; 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.