NPIMap

Organization Active NPI

Emergency Medicine Physicians of New Haven County,LLC

  • Emergency Medicine Physician
  • Meriden, CT
National Provider Identifier
1083910962
Registry record updated Feb 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGENCY MEDICINE PHYSICIANS OF NEW HAVEN COUNTY,LLC
Practice address
435 Lewis Ave
Meriden, CT 06451-2101
Phone
(203) 694-8200
NPI assigned
Feb 10, 2011
Last updated
Feb 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2011

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

Authorized official

Name
David C Packo, MDNPI 1497813281
Title
President
Phone
(330) 493-4443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

435 Lewis Ave
Meriden, CT 06451-2101

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 493-4443

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110427000166 CT Part B Supplier - Clinic/Group Practice 4284819764 Receives reassigned benefits from 96 practitioners
Practice locations: Stamford, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 120

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.

View all 120

NPI Registry JSON

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297296000000",
    "number": "1083910962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-493-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 LEWIS AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512101",
            "telephone_number": "203-694-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY MEDICINE PHYSICIANS OF NEW HAVEN COUNTY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-10",
        "last_updated": "2011-02-10",
        "status": "A",
        "authorized_official_last_name": "PACKO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-493-4443",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; 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.