NPIMap

Organization Active NPI

Active Orthopaedics PC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Middlebury, CT
National Provider Identifier
1083797401
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
034194 Issued in CT
Legal business name
ACTIVE ORTHOPAEDICS PC
Practice address
1579 Straits Turnpike
Middlebury, CT 06762
Phone
(203) 758-1272
Fax
(203) 758-1070
NPI assigned
Oct 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Michael J Kaplan, MDNPI 1124047196
Title
Orthopaedic Surgeon
Phone
(203) 758-1272

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
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 034194 CT Primary

Addresses

Primary practice location

1579 Straits Turnpike
Middlebury, CT 06762

Mailing address

1579 Straits Turnpike
Middlebury, CT 06762
Phone (203) 758-1272

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060327000707 CT Part B Supplier - Clinic/Group Practice 1759399165 Receives reassigned benefits from 7 practitioners
Practice locations: Middlebury, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1161388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083797401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1579 STRAITS TURNPIKE",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "06762",
            "telephone_number": "203-758-1272",
            "fax_number": "203-758-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1579 STRAITS TURNPIKE",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "06762",
            "telephone_number": "203-758-1272",
            "fax_number": "203-758-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE ORTHOPAEDICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAPLAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ORTHOPAEDIC SURGEON",
        "authorized_official_telephone_number": "203-758-1272",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CT",
            "license": "034194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.