Middlesex Plastic Surgery Center,LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

049437 Issued in CT

Legal business name

MIDDLESEX PLASTIC SURGERY CENTER,LLC

Practice address

535 Saybrook Rd
Middletown, CT 06457-4743

Phone

(860) 343-0122

Fax

(860) 347-2212

NPI assigned

Jul 29, 2011

Last updated

Jul 29, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mari Rebane-Mazzotta, MDNPI 1659599488

Title

Physician/Owner

Phone

(860) 343-0122

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

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.

• Mari Rebane-Mazzotta, MD

  • Plastic and Reconstructive Surgery Physician
  • Middletown, CT
  • NPI 1659599488
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311897600000",
    "number": "1174801898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 SAYBROOK RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574743",
            "telephone_number": "860-343-0122",
            "fax_number": "860-347-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 SAYBROOK RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574743",
            "telephone_number": "860-343-0122",
            "fax_number": "860-347-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLESEX PLASTIC SURGERY CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-29",
        "last_updated": "2011-07-29",
        "status": "A",
        "authorized_official_last_name": "REBANE-MAZZOTTA",
        "authorized_official_first_name": "MARI",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "860-343-0122",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CT",
            "license": "049437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWNER OPERATOR LIC #",
            "identifier": "049437",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Middlesex Hospital Paramedics (Middlesex Health Systems)
• Middlesex Laboratory Physicians, LLC
• Middlesex Neuropsychiatric Center
• Middlesex Orthopedic Surgeons PC
• Middlesex Orthopedic Surgeons Prof Corp
• Middlesex Rheumatology, LLC
• Middlesex Urology, PC.
• Middletown Dental Associates LLC
• Middletown Pharmacy Inc (Middletown Pharmacy)
• Middletown Smiles, LLC

• Plastic Surgery Physician in Middletown, CT
• Providers in Middletown, CT by specialty
• Plastic Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; 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.