Individual provider Active NPI

Tito L. Vasquez, M.D.

  • Plastic Surgery Physician
  • Southport, CT
National Provider Identifier
1083889398
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
046169 Issued in CT
Practice address
2600 Post Rd
Southport, CT 06890-1258
Phone
(203) 292-8119
Fax
(203) 292-8120
NPI assigned
Apr 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 046169 CT
Plastic Surgery Physician 208200000X 046169 CT Primary
Surgery of the Hand (Surgery) Physician 2086S0105X 046169 CT

Addresses

Primary practice location

2600 Post Rd
Southport, CT 06890-1258

Mailing address

2600 Post Rd
Southport, CT 06890-1258
Phone (203) 292-8119

Other identifiers 1

IdentifierTypeStateIssuer
D300000073OtherCTMEDICARE PTAN

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
I20090316000352 CT Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 8224059555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
New York Medical College, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

5520 Park Ave
Trumbull, CT 06611-3463
Phone (203) 785-4081

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

  • Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046169CTMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Oct 1, 2020 Accepting new patients
Yale University CurrentSince Oct 1, 2020 Accepting new patients
Yale University Past Accepting new patients
Fairfield Anesthesia Associates LLC Past Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

34 Maple St
Norwalk, CT 06850
Phone (203) 852-2000

2600 Post Rd
Ste 206
Southport, CT 06890
Phone (203) 292-8119

2600 Post Rd
Southport, CT 06890
Phone (203) 255-4005

32 Imperial Ave
Westport, CT 06880
Phone (203) 226-1760

Interoperability endpoints

  • Direct secure messaging: tito.vasquez@xdr.hhchealthdirect.org
  • Direct secure messaging: tvasquez7766@direct.ynhh.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1083889398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 POST RD",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901258",
            "telephone_number": "203-292-8119",
            "fax_number": "203-292-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 POST RD",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901258",
            "telephone_number": "203-292-8119",
            "fax_number": "203-292-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "TITO",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CT",
            "license": "046169",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CT",
            "license": "046169",
            "primary": true
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "CT",
            "license": "046169",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "D300000073",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, CT

Sources for this page

Verify at the official NPI Registry.