Individual provider Active NPI

Ann Mantua Asunto, M.D.

  • Family Medicine Physician
  • Stamford, CT
National Provider Identifier
1073747788
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
047312 Issued in CT
Practice address
22 5TH St
Stamford, CT 06905-5012
Phone
(203) 323-8160
NPI assigned
May 8, 2009
Last updated
Nov 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 047312 CT Primary
Family Medicine Physician 207Q00000X MT188452 PA

Addresses

Primary practice location

22 5TH St
Stamford, CT 06905-5012

Mailing address

805 Atlantic St
Stamford, CT 06902-6805
Phone (203) 327-5111

Other practice location 1

805 Atlantic St
Stamford, CT 06902-6805
Phone (203) 327-5111

Other identifiers 1

IdentifierTypeStateIssuer
004234788MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090831000374 CT Practitioner - Family Practice 7618022401 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
047312CTMDFamily Medicine Physician
MT188452PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Feb 1, 2014 Accepting new patients
Optimus Health Care Inc CurrentSince Jul 27, 2012 Accepting new patients
Community Health Center Inc Family Medicine CurrentSince Feb 1, 2014 Accepting new patients
Community Health Center Inc. Family Medicine Past Accepting new patients

Locations

471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864

982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260

575 Main St
Ste 2
Middletown, CT 06457

22 5th St
Stamford, CT 06905
Phone (203) 323-7760

805 Atlantic St
Stamford, CT 06902
Phone (203) 327-5111

Interoperability endpoints

  • Direct secure messaging: ann.asunto@chcict.eclinicaldirectplus.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1073747788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 ATLANTIC ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069026805",
            "telephone_number": "203-327-5111",
            "fax_number": "203-327-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 5TH ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055012",
            "telephone_number": "203-323-8160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "805 Atlantic St",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069026805",
            "country_code": "US",
            "telephone_number": "203-327-5111",
            "fax_number": "203-327-2991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASUNTO",
        "first_name": "ANN",
        "middle_name": "MANTUA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-08",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "047312",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT188452",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004234788",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.