Active NPI
Simon Andres Castro Montenegro, MD
- Internal Medicine Physician
- Bridgeport, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 69555
- Practice address
- 2800 Main St
Bridgeport, CT 06606-4201 - Phone
- (475) 210-5425
- NPI assigned
- Mar 24, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 69555 | CT | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2800 Main St
Bridgeport, CT 06606-4201
Mailing address
2800 Main St
Bridgeport, CT 06606-4201
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
80 Seymour St
Hartford, CT 06102-8000
Phone (860) 972-0549
Hospital & facility affiliations
- Hartford Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.42 of 100
- Quality
- 83.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.9
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69555 | CT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group Specialists, PLLC | Current | Accepting new patients | |
| Hartford Healthcare Medical Group Specialists LLC | Current | Accepting new patients | |
| SVMC Holdings, Inc | Past | Accepting new patients |
Locations
2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366
1 Lois St
Norwalk, CT 06851
Phone (203) 221-8893
1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
Interoperability endpoints
- simonandres.castromontenegro@xdr.hhchealthdirect.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Surgery Physician
- Hartford, CT
- NPI 1023584216
-
- Customized Equipment (DME)
- Groton, CT
- NPI 1295367068
-
- General Acute Care Hospital
- Bridgeport, CT
- NPI 1942224696
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1770696643
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1902834880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632873600000",
"number": "1144725029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066064201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066064201",
"telephone_number": "475-210-5425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTRO MONTENEGRO",
"first_name": "SIMON",
"middle_name": "ANDRES",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-24",
"last_updated": "2021-09-29",
"certification_date": "2021-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "69555",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bridgeport, CT
- Kettly Cassamajor
- Roberto J Castellon-Teran, LCSW
- Luis Alejandro Castellon Jr., BS
- Jairo Castillo, MD
- Karla Castillo
- Cathartic Breakthroughs, LLC
- Catholic Charities of Fairfield County, Inc.
- Catholic Charities of Fairfield County, Inc.
- Catholic Charities of Fairfield County, Inc.
- Lynda Kay Catuccio, PT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.