Individual provider Active NPI

Antonios J Panagiotakis, D.O.

  • Obstetrics & Gynecology Physician
  • Stamford, CT
National Provider Identifier
1083853550
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
050642 Issued in CT
Practice address
1275 Summer St
Stamford, CT 06905-5359
Phone
(203) 353-9099
Fax
(203) 353-9699
NPI assigned
Feb 6, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 050642 CT Primary

Addresses

Primary practice location

1275 Summer St
Stamford, CT 06905-5359

Mailing address

1275 Summer St
Stamford, CT 06905-5359
Phone (203) 353-9099

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
I20160315000872 CT Practitioner - Obstetrics/Gynecology 4688970874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Obstetrics and GynecologyGroup PAC ID 6901052414, 5 clinicians

Practice addresses (Care Compare)

999 Summer St
Suite 401
Stamford, CT 06905-5513
Phone (203) 353-9099

Hospital & facility affiliations

  • Stamford Hospital Hospital, Stamford, CT, CCN 070006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
050642CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Obstetrics and Gynecology PC Obstetrics & Gynecology CurrentSince Feb 1, 2016 Accepting new patients

Locations

999 Summer St
Ste 401
Stamford, CT 06905
Phone (203) 353-9099

999 Summer St
Stamford, CT 06905
Phone (203) 353-9099

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1083853550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 SUMMER ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055359",
            "telephone_number": "203-353-9099",
            "fax_number": "203-353-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 SUMMER ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055359",
            "telephone_number": "203-353-9099",
            "fax_number": "203-353-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANAGIOTAKIS",
        "first_name": "ANTONIOS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-06",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "050642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.