NPIMap

Organization Active NPI

Naugatuck Valley Radiological Associates PC

  • Diagnostic Radiology Physician
  • Waterbury, CT
National Provider Identifier
1114949799
Registry record updated Oct 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NAUGATUCK VALLEY RADIOLOGICAL ASSOCIATES PC
Practice address
56 Franklin St
Waterbury, CT 06706-1253
Phone
(203) 264-7999
Fax
(203) 264-7477
NPI assigned
Jul 24, 2006
Last updated
Oct 21, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2013

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

Authorized official

Name
Robert Gumbardo, MDNPI 1346274255
Title
Medical Director
Phone
(203) 264-7999

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
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

56 Franklin St
Waterbury, CT 06706-1253

Mailing address

385 Main St South
C/O Nvra Union Square BLDG #1
Southbury, CT 06488
Phone (203) 264-7999

Other identifiers 1

IdentifierTypeStateIssuer
004000949MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040218000142 CT Part B Supplier - Clinic/Group Practice 5092600189 Receives reassigned benefits from 16 practitioners
Practice locations: Southbury, CT

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

385 Main St S
Ofc
Southbury, CT 06488
Phone (203) 264-7999

Ownership & related parties

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382313600000",
    "number": "1114949799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 MAIN ST SOUTH",
            "address_2": "C/O NVRA UNION SQUARE BLDG #1",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "06488",
            "telephone_number": "203-264-7999",
            "fax_number": "203-264-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061253",
            "telephone_number": "203-264-7999",
            "fax_number": "203-264-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAUGATUCK VALLEY RADIOLOGICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2013-10-21",
        "status": "A",
        "authorized_official_last_name": "GUMBARDO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "203-264-7999",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004000949",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.