Organization Active NPI

Advanced Pain and Regenerative Medical Solutions Corp

  • Family Medicine Physician
  • Shelton, CT
National Provider Identifier
1245014331
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADVANCED PAIN AND REGENERATIVE MEDICAL SOLUTIONS CORP
Practice address
10 Progress Dr
Shelton, CT 06484-6293
Phone
(203) 948-8127
NPI assigned
Aug 21, 2023
Last updated
Sep 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
David Waltzer, DCNPI 1114565033
Title
Owner
Phone
(203) 948-8127

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

10 Progress Dr
Shelton, CT 06484-6293

Mailing address

10 Progress Dr Ste 2F
Shelton, CT 06484-6294

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240405002424 CT Part B Supplier - Clinic/Group Practice 4587002712 Receives reassigned benefits from 7 practitioners
Practice locations: Shelton, CT

National Provider Directory

National Provider Directory

Locations

500 E Main St
Branford, CT 06405
Phone (203) 481-5665

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1245014331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PROGRESS DR STE 2F",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PROGRESS DR",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846293",
            "telephone_number": "203-948-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PAIN AND REGENERATIVE MEDICAL SOLUTIONS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "WALTZER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-948-8127",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.