Individual provider Active NPI

Stephanie Foster, DO

  • Pediatrics Physician
  • Middletown, CT
National Provider Identifier
1134706690
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
78133 Issued in CT
Practice address
400 Saybrook Rd Ste 206
Middletown, CT 06457-4775
Phone
(860) 344-0333
NPI assigned
Mar 29, 2021
Last updated
Jul 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 78133 CT Primary

Addresses

Primary practice location

400 Saybrook Rd Ste 206
Middletown, CT 06457-4775

Mailing address

12 Pine RDG
Woodbridge, CT 06525-1815
Phone (203) 980-6803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240814002146 CT Practitioner - Pediatric Medicine 4082152699 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
78133CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Pediatrics CurrentSince Aug 12, 2024 Accepting new patients

Locations

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

400 Saybrook Rd
Ste 206
Middletown, CT 06457
Phone (860) 344-0333

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1134706690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PINE RDG",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065251815",
            "telephone_number": "203-980-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SAYBROOK RD STE 206",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574775",
            "telephone_number": "860-344-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "STEPHANIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "78133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.