Northeastern Nephrology Associates, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

029990 Issued in CT

Legal business name

NORTHEASTERN NEPHROLOGY ASSOCIATES, PC

Practice address

281 Hartford Tpke
Suite 210
Vernon, CT 06066-4784

Phone

(860) 872-8563

Fax

(860) 870-4857

NPI assigned

Feb 7, 2007

Last updated

Jan 23, 2012By 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

Angelito C Bacay, M.D.NPI 1679506836

Title

President

Phone

(860) 872-8563

Specialties & licenses 2

Addresses

Locations

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10060336

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.

• Angelito C Bacay, MD

  • Specialist
  • Vernon, CT
  • NPI 1679506836
  Authorized official Same address or phone

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1235279787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 HARTFORD TPKE",
            "address_2": "SUITE 210",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664784",
            "telephone_number": "860-872-8563",
            "fax_number": "860-870-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 HARTFORD TPKE",
            "address_2": "SUITE 210",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664784",
            "telephone_number": "860-872-8563",
            "fax_number": "860-870-4857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN NEPHROLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "BACAY",
        "authorized_official_first_name": "ANGELITO",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-872-8563",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "029990",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CT",
            "license": "029990",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Northland Hearing Centers (Hear Again Center)
• Northland Hearing Centers, Inc. (Hear Again Center)

• Specialist in Vernon, CT
• Providers in Vernon, CT by specialty
• Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.