NPIMap

Organization Active NPI

Middlesex Gastroenterology Associates, LLC

  • Gastroenterology Physician
  • Middletown, CT
National Provider Identifier
1205894375
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
025965 Issued in CT
Legal business name
MIDDLESEX GASTROENTEROLOGY ASSOCIATES, LLC
Practice address
410 Saybrook Road
Suite 201
Middletown, CT 06457-4747
Phone
(860) 347-4620
Fax
(860) 346-9687
NPI assigned
May 1, 2006
Last updated
Aug 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Authorized official

Name
Mario Ricci, MDNPI 1124130760
Title
Managing Partner
Phone
(860) 347-4620

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 025965 CT Primary

Addresses

Primary practice location

410 Saybrook Road
Suite 201
Middletown, CT 06457-4747

Mailing address

410 Saybrook Road
Suite 201
Middletown, CT 06457-4747
Phone (860) 347-4620

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325000699 CT Part B Supplier - Clinic/Group Practice 5597657627 Receives reassigned benefits from 13 practitioners
Practice locations: Middletown, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D0710066Middlesex Gastroenterology Associates, LLC410 Saybrook Rd Ste 202, Middletown, CT 06457ComplianceMay 16, 2027

National Provider Directory

National Provider Directory

Locations

12 Plains Rd
Essex, CT 06426

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1205894375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 SAYBROOK ROAD",
            "address_2": "SUITE 201",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574747",
            "telephone_number": "860-347-4620",
            "fax_number": "860-346-9687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 SAYBROOK ROAD",
            "address_2": "SUITE 201",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574747",
            "telephone_number": "860-347-4620",
            "fax_number": "860-346-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLESEX GASTROENTEROLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "RICCI",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "860-347-4620",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "025965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.