Active NPI
Beacon Falls Medical Association, LLC
- Gastroenterology Physician
- Naugatuck, CT
National Provider Identifier
1093731291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 035834
- Legal business name
- BEACON FALLS MEDICAL ASSOCIATION, LLC
- Practice address
- 202 Water St
Naugatuck, CT 06770-2803 - Phone
- (203) 729-6644
- NPI assigned
- Jul 14, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jose R Orellana
- Title
- President
- Phone
- (203) 729-6644
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 035834 | CT | Primary |
| Gastroenterology Physician | 207RG0100X | 035801 | CT |
Addresses
Primary practice location
202 Water St
Naugatuck, CT 06770-2803
Mailing address
202 Water St
Naugatuck, CT 06770-2803
Phone (203) 729-6644
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CG6464 | Other | CT | RAILROAD MEDICARE |
| 50BEFALLSCT01 | Other | CT | ANTHEM BC/BS |
National Provider Directory
National Provider DirectoryLocations
202 Water St
Naugatuck, CT 06770
Phone (203) 723-1901
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Internal Medicine Physician
- Southington, CT
- NPI 1073532339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1093731291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 WATER ST",
"city": "NAUGATUCK",
"state": "CT",
"postal_code": "067702803",
"telephone_number": "203-729-6644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 WATER ST",
"city": "NAUGATUCK",
"state": "CT",
"postal_code": "067702803",
"telephone_number": "203-729-6644"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEACON FALLS MEDICAL ASSOCIATION, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-14",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ORELLANA",
"authorized_official_first_name": "JOSE",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "203-729-6644"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CT",
"license": "035834",
"primary": true
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CT",
"license": "035801",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CG6464",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "50BEFALLSCT01",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Naugatuck, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.