Connecticut Back Center LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

CONNECTICUT BACK CENTER LLC

Practice address

460 Hartford Tpke
Suite B
Vernon, CT 06066-4845

Phone

(860) 872-6229

Fax

(860) 872-6252

NPI assigned

Jun 10, 2006

Organization subpart

No

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

Authorized official

Name

Amy Eisler

Title

Office Manager

Phone

(860) 872-6229

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Connecticut Back Center LLC

  • Orthopedic Physical Therapist
  • Vernon, CT
  • NPI 1245837384

  O20050913000195

  Same enrollment

Subparts reporting this organization as parent 1

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

• Connecticut Back Center LLC

  • Orthopedic Physical Therapist
  • Vernon, CT
  • NPI 1245837384
  NPPES parent name

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jesse Eisler, M.D.

  • Orthopaedic Surgery Physician
  • Vernon, CT
  • NPI 1326017617
  Medicare reassignment Care Compare group NPD
• Andrew Paul Thomas Gregory, D.C., FNP-C, R.NCS.T

  • Family Nurse Practitioner
  • Vernon, CT
  • NPI 1114961703
  Medicare reassignment Care Compare group NPD
• Justin J Lecuyer, PA-C

  • Surgical Physician Assistant
  • Hartford, CT
  • NPI 1184335374
  Medicare reassignment Care Compare group
• Christine Bergeron, PT

  • Physical Therapist
  • Manchester, CT
  • NPI 1518976489
  Medicare reassignment NPD
• Betty Joseph, PT

  • Physical Therapist
  • Bloomfield, CT
  • NPI 1346207073
  Medicare reassignment NPD
• Ashish Upadhyay, MD

  • Orthopaedic Surgery of the Spine Physician
  • Waterbury, CT
  • NPI 1689873457
  Medicare reassignment NPD
• Shahin Shaikh, PA-C

  • Physician Assistant
  • Hamden, CT
  • NPI 1649655226
  Medicare reassignment

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1174564942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 HARTFORD TPKE",
            "address_2": "SUITE B",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664845",
            "telephone_number": "860-872-6229",
            "fax_number": "860-872-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 HARTFORD TPKE",
            "address_2": "SUITE B",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664845",
            "telephone_number": "860-872-6229",
            "fax_number": "860-872-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT BACK CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "EISLER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "860-872-6229"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Collins, PT
• Abdullah Emilio Colon
• Complete Care at Fox Hill LLC
• Concordia Counseling of Connecticut LLC
• Constandina Patricia Conley, APRN, FNP-BC
• Connecticut Back Center LLC
• Connecticut CVS Pharmacy LLC
• Connecticut East Dental Center, LLC
• Marykate Elizabeth Connolly, MSW
• Kathleen A Cooper, PA

• Orthopaedic Surgery Physician in Vernon, CT
• Providers in Vernon, CT by specialty
• Orthopaedic Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.