NPIMap

Organization Active NPI

Seacoast Orthopedic Surgery & Sports Medicine LLC

  • Orthopaedic Surgery Physician
  • Groton, CT
National Provider Identifier
1114979614
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SEACOAST ORTHOPEDIC SURGERY & SPORTS MEDICINE LLC
Practice address
495 Route 184
Suite 300
Groton, CT 06340
Phone
(860) 449-1413
Fax
(860) 449-0390
NPI assigned
May 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Authorized official

Name
Steven B Carlow, MDNPI 1013935592
Title
Doctor
Phone
(860) 449-1413

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
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

495 Route 184
Suite 300
Groton, CT 06340

Mailing address

495 Route 184
Suite 300
Groton, CT 06340
Phone (860) 449-1413

Other identifiers 6

IdentifierTypeStateIssuer
047870OtherCTLICENSE NUMBER
001409756MedicaidCT
001272939MedicaidCT
040975OtherCTLICENSE NUMBER
001253582MedicaidCT
004237146MedicaidCT

National Provider Directory

National Provider Directory

Locations

495 Gold Star Hwy
Ste 301
Groton, CT 06340

495 Route 184
Ste 300
Groton, CT 06340
Phone (860) 449-1413

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358899200000",
    "number": "1114979614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 ROUTE 184",
            "address_2": "SUITE 300",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340",
            "telephone_number": "860-449-1413",
            "fax_number": "860-449-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 ROUTE 184",
            "address_2": "SUITE 300",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340",
            "telephone_number": "860-449-1413",
            "fax_number": "860-449-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEACOAST ORTHOPEDIC SURGERY & SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2013-01-23",
        "status": "A",
        "authorized_official_last_name": "CARLOW",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "860-449-1413",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "047870",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001409756",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001272939",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "040975",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001253582",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004237146",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; 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.