Telebup, LLC

Primary specialty

Addiction Medicine (Anesthesiology) PhysicianTaxonomy code 207LA0401X

Legal business name

TELEBUP, LLC

Practice address

2 Ledgebrook Dr FL 2
Mansfield Center, CT 06250-1682

Phone

(860) 230-3294

NPI assigned

Apr 13, 2020

Organization subpart

No

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

Authorized official

Name

Dr. David L. Simon, M.D., J.D.NPI 1962736611

Title

Chief Managing Officer

Phone

(860) 230-3294

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• David L Simon, M.D., J.D.

  • Addiction Medicine (Anesthesiology) Physician
  • Mansfield Center, CT
  • NPI 1962736611
  NPD Authorized official

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1245859958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 618",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062500618",
            "telephone_number": "860-230-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LEDGEBROOK DR FL 2",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501682",
            "telephone_number": "860-230-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELEBUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-13",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHIEF MANAGING OFFICER",
        "authorized_official_telephone_number": "860-230-3294",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., J.D."
    },
    "taxonomies": [
        {
            "code": "207LA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Sustaita, LPC
• Mary Wattick Sutterfield, APRN FNP-C
• Angellina Swart, LCSW
• Tamara Vertefeuille, LLC
• Chelsea Teasdale, LPC
• Tianna Teles-Rosario, LMSW-T
• Sylvia Toledo-Cruz
• Priscilla Torres
• Yuri Troshin, FNP
• Adrianna Tuomi

• Anesthesiology Physician in Mansfield Center, CT
• Providers in Mansfield Center, CT by specialty
• Anesthesiology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.