Individual provider Active NPI

Michael M Passaretti, MD

  • Orthopaedic Surgery Physician
  • Manchester, CT
National Provider Identifier
1255395745
Registry record updated Feb 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
017533 Issued in CT
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

Updated by the provider on Feb 24, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
001175330MedicaidCT

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

LicenseStateTypeSpecialty
017533CTMDSpecialist
0000000000CTMDFamily 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.

Verify at the official NPI Registry.