Holistic Family Medicine LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

000278 Issued in CT

Legal business name

HOLISTIC FAMILY MEDICINE LLC

Practice address

430 Old Sib Rd
Ridgefield, CT 06877-2335

Phone

(203) 826-3582

Fax

(855) 798-2816

NPI assigned

Mar 18, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Domenick John Masiello, DONPI 1184747305

Title

Owner

Phone

(203) 826-3582

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Holistic Family Medicine LLC

  • Family Medicine Physician
  • New York, NY
  • NPI 1376895797

  9436394681

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Holistic Family Medicine LLC

  • Family Medicine Physician
  • New York, NY
  • NPI 1376895797

  O20130319000003

  Same enrollment

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Domenick John Masiello, DO

  • Neuromusculoskeletal Medicine & OMM Physician
  • Ridgefield, CT
  • NPI 1184747305
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363564800000",
    "number": "1114269032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 OLD SIB RD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068772335",
            "telephone_number": "203-826-3582",
            "fax_number": "855-798-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 OLD SIB RD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068772335",
            "telephone_number": "203-826-3582",
            "fax_number": "855-798-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-18",
        "last_updated": "2013-03-18",
        "status": "A",
        "authorized_official_last_name": "MASIELLO",
        "authorized_official_first_name": "DOMENICK",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-826-3582",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CT",
            "license": "000278",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "000278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucy Heffernan, LCSW
• Shauna Rene Foy Henschel, BCBA, LBA
• Jason B Hill
• Cynthia A Hoff, D.C.
• Sharon Fudge Hoffner, DPT
• Home Care by Rvna, LLC
• Home Town Dental Inc
• Kelley Hopkins-Alvarez, LPC
• Kimberly Hopkins, PT, DPT
• Yonathan Hormadaly

• Family Medicine Physician in Ridgefield, CT
• Providers in Ridgefield, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2013; 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.