NPIMap

Individual provider Active NPI

Edmund F Caporaso, MD

  • Internal Medicine Physician
  • Waterbury, CT
National Provider Identifier
1285623538
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0262476 Issued in CT
Practice address
1567 E Main St
Waterbury, CT 06705-1026
Phone
(203) 597-9778
Fax
(203) 757-0367
NPI assigned
Oct 19, 2005
Last updated
Jan 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0262476 CT Primary

Addresses

Primary practice location

1567 E Main St
Waterbury, CT 06705-1026

Mailing address

1567 E Main St
Waterbury, CT 06705-1026
Phone (203) 597-9778

Other identifiers 1

IdentifierTypeStateIssuer
1262476MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100818000002 CT Practitioner - Internal Medicine 6901930551 Practice locations: Waterbury, CT

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York Medical College, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1567 E Main St
Waterbury, CT 06705-1026

1567 E Main St
Waterbury, CT 06705-1029
Phone (203) 597-9778

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0262476CTMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: ecaporaso@direct.wtbyhosp.org

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1285623538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1567 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051026",
            "telephone_number": "203-597-9778",
            "fax_number": "203-757-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1567 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051026",
            "telephone_number": "203-597-9778",
            "fax_number": "203-757-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPORASO",
        "first_name": "EDMUND",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "0262476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1262476",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.