NPIMap

Organization Active NPI

Milford Vascular Institute, PC

  • Vascular Surgery Physician
  • Milford, CT
National Provider Identifier
1235701335
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
MILFORD VASCULAR INSTITUTE, PC
Practice address
20 Commerce Park
Milford, CT 06460-3511
Phone
(203) 882-8346
Fax
(203) 882-0384
NPI assigned
Jul 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Authorized official

Name
Miss Ashley Fitzgerald
Title
Office Manager
Phone
(203) 882-8346

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X

Addresses

Primary practice location

20 Commerce Park
Milford, CT 06460-3511

Mailing address

20 Commerce Park
Milford, CT 06460-3511
Phone (203) 882-8346

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211110000758 CT Part B Supplier - Clinic/Group Practice 0446649685 Receives reassigned benefits from 10 practitioners
Practice locations: Milford, CT; Westport, CT; Danbury, CT; Cheshire, CT

National Provider Directory

National Provider Directory

Locations

203 Main St
East Haven, CT 06512
Phone (203) 407-2541

20 Commerce Park
Milford, CT 06460
Phone (203) 283-5200

10 Commerce Park
Milford, CT 06460
Phone (203) 882-8346

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24043/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626393600000",
    "number": "1235701335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 COMMERCE PARK",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603511",
            "telephone_number": "203-882-8346",
            "fax_number": "203-882-0384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 COMMERCE PARK",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603511",
            "telephone_number": "203-882-8346",
            "fax_number": "203-882-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILFORD VASCULAR INSTITUTE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-07-16",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "203-882-8346",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.