Individual provider Active NPI

Edward Feliciano, M.D.

  • Orthopaedic Surgery Physician
  • Stamford, CT
National Provider Identifier
1265587802
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
048201 Issued in CT
Practice address
1 Blachley Rd
Stamford, CT 06902-0001
Phone
(203) 276-2277
Fax
(203) 276-2278
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 048201 CT Primary

Addresses

Primary practice location

1 Blachley Rd
Stamford, CT 06902-0001

Mailing address

1 Blachley Rd
Stamford, CT 06902-0001
Phone (203) 276-2277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091214000142 CT Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 6103963426 Reassigns benefits to 2 organizations
I20230830000008 NJ Practitioner - Orthopedic Surgery 6103963426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Coast Spine Joint and Sports MedicineGroup PAC ID 2365530938, 14 clinicians

Practice addresses (Care Compare)

720 Monroe St
Suite C208
Hoboken, NJ 07030-6350
Phone (201) 533-9200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
048201CTMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Coast Spine Joint and Sports Medicine CurrentSince Jul 20, 2023 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Nov 1, 2018 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Nov 1, 2018 Accepting new patients
Bristol Hospital Multi Specialty Group, Inc Orthopaedic Surgery CurrentSince Oct 23, 2020 Accepting new patients
Avalon Medical Center, LLC Orthopaedic Surgery Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

15 Riverside Ave
Bristol, CT 06010
Phone (860) 516-7593

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

720 Monroe St
Ste E304
Hoboken, NJ 07030

720 Monroe St
Ste C208
Hoboken, NJ 07030
Phone 20153392001005

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1265587802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BLACHLEY RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069020001",
            "telephone_number": "203-276-2277",
            "fax_number": "203-276-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BLACHLEY RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069020001",
            "telephone_number": "203-276-2277",
            "fax_number": "203-276-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELICIANO",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CT",
            "license": "048201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.