Individual provider Active NPI

Panayotes Yannopoulos, MD

  • Internal Medicine Physician
  • Stratford, CT
National Provider Identifier
1245323641
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
000333 Issued in CT
Practice address
1825 Barnum Ave
Stratford, CT 06614
Phone
(203) 370-5493
Fax
(203) 380-0874
NPI assigned
Sep 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 000333 CT Primary

Addresses

Primary practice location

1825 Barnum Ave
Stratford, CT 06614

Mailing address

1825 Barnum Ave
Stratford, CT 06614
Phone (203) 370-5493

Other identifiers 1

IdentifierTypeStateIssuer
1003334MedicaidCT

Other names 1

  • Peter Yannopoulos Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100909001155 CT Practitioner - Internal Medicine 1052470531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians

Practice addresses (Care Compare)

1825 Barnum Ave
Stratford, CT 06614-5333
Phone (203) 377-5493

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

Hospital & facility affiliations

  • Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
000333CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Medical Associates Internal Medicine CurrentSince Sep 26, 1995 Accepting new patients

Locations

1825 Barnum Ave
Ste 205
Stratford, CT 06614
Phone (203) 377-5493

1825 Barnum Ave
Ste 203
Stratford, CT 06614
Phone (203) 377-5493

1825 Barnum Ave
Stratford, CT 06614
Phone (203) 377-1777

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1245323641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 BARNUM AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "06614",
            "telephone_number": "203-370-5493",
            "fax_number": "203-380-0874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 BARNUM AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "06614",
            "telephone_number": "203-370-5493",
            "fax_number": "203-380-0874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANNOPOULOS",
        "first_name": "PANAYOTES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "000333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003334",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PETER",
            "last_name": "YANNOPOULOS",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stratford, CT

Sources for this page

Verify at the official NPI Registry.