NPIMap

Organization Active NPI

Ear Specialty Group of Connecticut PC

  • Otology & Neurotology Physician
  • Farmington, CT
National Provider Identifier
1174005219
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otology & Neurotology PhysicianTaxonomy code 207YX0901X
Legal business name
EAR SPECIALTY GROUP OF CONNECTICUT PC
Practice address
40 Stanford Dr
Farmington, CT 06032-2454
Phone
(860) 640-4455
Fax
(860) 640-4478
NPI assigned
Sep 5, 2018
Last updated
Nov 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Authorized official

Name
Susan Hannah Rostron, AUDNPI 1598849697
Title
Director of Operations
Phone
(860) 640-4455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otology & Neurotology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0901X Primary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X

Addresses

Primary practice location

40 Stanford Dr
Farmington, CT 06032-2454

Mailing address

40 Stanford Dr
Farmington, CT 06032-2454
Phone (860) 640-4455

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181016002702 CT Part B Supplier - Clinic/Group Practice 0446502686 Receives reassigned benefits from 7 practitioners
Practice locations: Farmington, CT

National Provider Directory

National Provider Directory

Locations

40 Stanford Dr
Farmington, CT 06032
Phone (860) 640-4455

40 Stanford Dr
Ste 100
Farmington, CT 06032

Practitioners & affiliated clinicians

Practitioners 7

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": "1536105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1174005219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 STANFORD DR",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322454",
            "telephone_number": "860-640-4455",
            "fax_number": "860-640-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 STANFORD DR",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322454",
            "telephone_number": "860-640-4455",
            "fax_number": "860-640-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR SPECIALTY GROUP OF CONNECTICUT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-05",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "ROSTRON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "HANNAH",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "860-640-4455",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.