Active NPI
Michael Packman, MD
- Anesthesiology Physician
- Bridgeport, CT
National Provider Identifier
1205856333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 22889
- Practice address
- 267 Grant St
Bridgeport Anesthesia Associates, P.C.
Bridgeport, CT 06610-2805 - Phone
- (203) 384-3000
- NPI assigned
- Jul 20, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 22889 | CT | Primary |
Addresses
Primary practice location
267 Grant St
Bridgeport Anesthesia Associates, P.C.
Bridgeport, CT 06610-2805
Mailing address
7365 Main St
Bridgeport Anesthesia Associates, P.C.
Stratford, CT 06614-1300
Phone (203) 384-3174
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CHN1086 | Other | CT | COMMUNITY HEALTH NETWORK |
| 1228891 | Medicaid | CT | |
| 2889 | Other | CT | CONNECTICARE |
| 500HBA011CT01 | Other | CT | BCBS CT |
| 95012 | Other | CT | HEALTH NET |
| A770995 | Other | CT | OXFORD HEALTH PLANS |
| 060855634003E011 | Other | CT | CIGNA CT |
| 4402597 | Other | CT | AETNA CT |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22889 | CT | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256601600000",
"number": "1205856333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7365 MAIN ST",
"address_2": "BRIDGEPORT ANESTHESIA ASSOCIATES, P.C.",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066141300",
"telephone_number": "203-384-3174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "267 GRANT ST",
"address_2": "BRIDGEPORT ANESTHESIA ASSOCIATES, P.C.",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066102805",
"telephone_number": "203-384-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACKMAN",
"first_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2009-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CT",
"license": "22889",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY HEALTH NETWORK",
"identifier": "CHN1086",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1228891",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "2889",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS CT",
"identifier": "500HBA011CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "95012",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLANS",
"identifier": "A770995",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA CT",
"identifier": "060855634003E011",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA CT",
"identifier": "4402597",
"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 Oct 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.