Active NPI
Michael M Passaretti, MD
- Orthopaedic Surgery Physician
- Manchester, CT
National Provider Identifier
1255395745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 017533
- Practice address
- 36 Haynes St
Manchester, CT 06040-4105 - Phone
- (860) 646-0188
- Fax
- (860) 645-9573
- NPI assigned
- Apr 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 017533 | CT | Primary |
| Specialist | 174400000X | 017533 | CT |
Addresses
Primary practice location
36 Haynes St
Manchester, CT 06040-4105
Mailing address
36 Haynes St
Manchester, CT 06040-4105
Phone (860) 646-0188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001175330 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017533 | CT | MD | Specialist |
| 0000000000 | CT | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235433600000",
"number": "1255395745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 HAYNES ST",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060404105",
"telephone_number": "860-646-0188",
"fax_number": "860-645-9573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 HAYNES ST",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060404105",
"telephone_number": "860-646-0188",
"fax_number": "860-645-9573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASSARETTI",
"first_name": "MICHAEL",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-13",
"last_updated": "2009-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CT",
"license": "017533",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CT",
"license": "017533",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001175330",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Manchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.