Mount Carmel Internal Medicine and Geriatrics LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MOUNT CARMEL INTERNAL MEDICINE AND GERIATRICS LLC

Practice address

680 S Main St
Suite 205
Cheshire, CT 06410-3181

Phone

(203) 699-9898

Fax

(203) 250-7878

NPI assigned

Jul 14, 2005

Organization subpart

No

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

Authorized official

Name

Maria N.C. Stack, M.D.NPI 1861490104

Title

President

Phone

(203) 699-9898

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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.

• Maria N.C. Stack, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Cheshire, CT
  • NPI 1861490104
  Authorized official Same address or phone

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1104824978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BIRCH ST",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602127",
            "telephone_number": "301-990-3995",
            "fax_number": "702-447-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 S MAIN ST",
            "address_2": "SUITE 205",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103181",
            "telephone_number": "203-699-9898",
            "fax_number": "203-250-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT CARMEL INTERNAL MEDICINE AND GERIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2022-07-21",
        "certification_date": "2020-03-20",
        "status": "A",
        "authorized_official_last_name": "STACK",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "N.C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-699-9898",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001285148",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Nicole Morgan, DPT
• Kelly Susan Morrison, D.M.D.
• Daniel Morton, BCBA
• Josh Mosdale, M.D.
• Jeramie Jason Mota
• Mrowka Physical Therapy PC
• Colleen M. Mrowka, P.T., D.P.T.
• Sara Mulligan
• Multicare Physicians & Rehabilitation Group P.C.
• Carlos Munoz

• Internal Medicine Physician in Cheshire, CT
• Providers in Cheshire, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.