Michael J Cavaliere MD PC | NPI 1235455635

Key facts

NPI: 1235455635
Entity type: Organization (NPI type 2)
Primary specialty: Internal Medicine Physician 207R00000X
License: 017049 (CT)
Legal business name: MICHAEL J CAVALIERE MD PC
Practice address: 3363 Main Street
BPT, CT 06606-4285
Phone: (203) 333-2568
Fax: (203) 372-8923
NPI assigned: Apr 12, 2010
Organization subpart: No

Authorized official

Name: Dr. Michael John Cavaliere, MD
Title: President
Phone: (203) 333-2568

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Michael John Cavaliere, MD Internal Medicine Physician · Bridgeport, CT · NPI 1194713339

Medicare reassignment NPD CT · INTERNAL MEDICINE

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
07D0099441	Michael J Cavaliere MD 3363 Main, Bridgeport, CT 06606	Certificate of waiver	Aug 31, 2026

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CT

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20100513000327	CT	Part B Supplier - Clinic/Group Practice	6800924747	Receives reassigned benefits from 1 practitioner Practice locations: Bridgeport, CT

National Provider Directory

Locations

3363 Main St
Bridgeport, CT 06606
Phone (203) 333-2568

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	207R00000X	017049	CT	Yes

Addresses

Primary practice location

3363 Main Street
BPT, CT 06606-4285

Mailing address

3363 Main Street
Bridgeport, CT 06606-4285
Phone (203) 333-2568

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.