Individual provider Active NPI

Karol Joseph Chacho, MD

  • Reproductive Endocrinology Physician
  • Bridgeport, CT
National Provider Identifier
1174630651
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
025272 Issued in CT
Practice address
4699 Main St
Suite 210
Bridgeport, CT 06606
Phone
(203) 372-5282
Fax
(203) 372-9025
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 025272 CT Primary

Addresses

Primary practice location

4699 Main St
Suite 210
Bridgeport, CT 06606

Mailing address

4699 Main St
Suite 210
Bridgeport, CT 06606
Phone (203) 372-5282

Other identifiers 3

IdentifierTypeStateIssuer
000362OtherCTHEALTHNET
010025272CT01OtherCTANTHEM BCBS
709157OtherCTCONNECTICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
025272CTMDReproductive Endocrinology Physician

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174630651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4699 MAIN ST",
            "address_2": "SUITE 210",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "203-372-5282",
            "fax_number": "203-372-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4699 MAIN ST",
            "address_2": "SUITE 210",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "203-372-5282",
            "fax_number": "203-372-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACHO",
        "first_name": "KAROL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "CT",
            "license": "025272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "000362",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "010025272CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "709157",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.