Mikhail Altan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

13795 Issued in CT

Practice address

17 Heritage Dr
Seymour, CT 06483-3841

Phone

(203) 610-1148

NPI assigned

Dec 10, 2024

Sex

Male

Sole proprietor

No

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.

• Connecticut Gi PLLC

  • Gastroenterology Physician
  • Hartford, CT
  • NPI 1023124625
  Medicare reassignment Care Compare group NPD CT · FAMILY
• Litchfield County Gastroenterology Associates, LLC

  • Gastroenterology Physician
  • Torrington, CT
  • NPI 1871513283
  NPD (past)

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

• Prospect Waterbury, Inc.

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1477902641
  Care Compare affiliation Hospital

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Connecticut Gi PLLC 243 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Waterbury Hospital Hospital, Waterbury, CT, CCN 070005

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: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 10, 2024.

{
    "created_epoch": "1733788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1265248561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 HERITAGE DR",
            "city": "SEYMOUR",
            "state": "CT",
            "postal_code": "064833841",
            "telephone_number": "203-610-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 HERITAGE DR",
            "city": "SEYMOUR",
            "state": "CT",
            "postal_code": "064833841",
            "telephone_number": "203-610-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTAN",
        "first_name": "MIKHAIL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-10",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "13795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janai Albelo
• Kerri Ann Anderson, LMFT
• Dawn Andrade, APRN
• Arun J Madhani DDS LLC
• Donovan Beattie
• Best Life Counseling LLC

• All providers in Seymour, CT
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.