Igor Samegulin, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

049234 Issued in CT

Practice address

74 Park Rd
West Hartford, CT 06119-1853

Phone

(860) 218-1725

Fax

(860) 218-1727

NPI assigned

Jan 21, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Family PracticeAlso: Hospitalist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Middlesex HospitalGroup PAC ID 5092611731, 231 clinicians

West Hartford Medical CenterGroup PAC ID 4284764598, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: isamegulin14684@middlesexhealthprd.direct-ci.com

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.

• Middlesex Hospital

  dba Middlesex Hospital dba Middlesex Hospital Physician Services

  • Family Nurse Practitioner
  • Middletown, CT
  • NPI 1972563138

  Family Medicine

  Medicare reassignment Care Compare group NPD
• West Hartford Medical Center

  • Family Medicine Physician
  • West Hartford, CT
  • NPI 1942533039
  Medicare reassignment Care Compare group NPD
• Middlesex Hospital

  dba Middlesex Hospital Homecare and Hospice

  • Community Based Hospice Care Agency
  • Middletown, CT
  • NPI 1003873233

  Family Medicine

  NPD

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

• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  Care Compare affiliation

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

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1255517249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 PARK RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191853",
            "telephone_number": "860-218-1725",
            "fax_number": "860-218-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 PARK RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191853",
            "telephone_number": "860-218-1725",
            "fax_number": "860-218-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMEGULIN",
        "first_name": "IGOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-21",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "049234",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "49234",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008023148",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Saint Mary Home -Adult Day Care
• Saint Mary Home, Incorporated
• Donald James Salzberg, MD
• Sam Starr, MSW, LCSW, LLC
• Arman Samad-Zadeh
• Amitoj Kaur Samra, DDS
• Diane Samuels, LMFT
• Jesse Samuels, M.D.
• Sarah Ashton Sanford, APRN
• Tatiana Isis Santana-Morin

• Family Medicine Physician in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.