NPIMap

Individual provider Active NPI

Teo-Carlo Straun, M.D.

  • Psychiatry Physician
  • Berlin, CT
National Provider Identifier
1235339219
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
050844 Issued in CT
Practice address
279 New Britain Rd Ste a
Berlin, CT 06037-3165
Phone
(860) 756-0455
Fax
(866) 469-7058
NPI assigned
Jul 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 050844 CT
Psychiatry Physician 2084P0800X 243925 MA
Addiction Psychiatry Physician 2084P0802X 243925 MA
Addiction Psychiatry Physician 2084P0802X 050844 CT
Psychiatry Physician 2084P0800X 050844 CT Primary

Addresses

Primary practice location

279 New Britain Rd Ste a
Berlin, CT 06037-3165

Mailing address

279 New Britain Rd Ste a
Berlin, CT 06037-3165
Phone (860) 756-0455

Other identifiers 1

IdentifierTypeStateIssuer
008068404MedicaidCT

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

LicenseStateTypeSpecialty
050844CTMDAddiction Medicine (Psychiatry & Neurology) Physician
243925MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JD Quality Nurse Practitioner Services, LLC Past Accepting new patients
Straun Health & Wellness Psychiatry Past Accepting new patients
Waterview Clinical Services LLC Psychiatry Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: teo-carlo.straun.1@23172.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23172/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1235339219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 NEW BRITAIN RD STE A",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060373165",
            "telephone_number": "860-756-0455",
            "fax_number": "866-469-7058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 NEW BRITAIN RD STE A",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060373165",
            "telephone_number": "860-756-0455",
            "fax_number": "866-469-7058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRAUN",
        "first_name": "TEO-CARLO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "CT",
            "license": "050844",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "243925",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "MA",
            "license": "243925",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CT",
            "license": "050844",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "050844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008068404",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; 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.