NPIMap

Organization Active NPI

Usacs of Connecticut, LLC

  • Emergency Medicine Physician
  • Bristol, CT
National Provider Identifier
1285713099
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
USACS OF CONNECTICUT, LLC
Practice address
41 Brewster Rd
Bristol, CT 06010-5161
Phone
(330) 493-4443
Fax
(330) 493-8677
NPI assigned
Nov 3, 2006
Last updated
Oct 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Authorized official

Name
Dominic J Bagnoli Jr., MDNPI 1659439453
Title
Exec Chair
Phone
(330) 493-4443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X NU

Addresses

Primary practice location

41 Brewster Rd
Bristol, CT 06010-5161

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 493-4443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070111000383 CT Part B Supplier - Clinic/Group Practice 9638179880 Receives reassigned benefits from 74 practitioners
Practice locations: Bristol, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 134

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 134

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1285713099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-493-4443",
            "fax_number": "330-493-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 BREWSTER RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105161",
            "telephone_number": "330-493-4443",
            "fax_number": "330-493-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USACS OF CONNECTICUT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "BAGNOLI",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXEC CHAIR",
        "authorized_official_telephone_number": "330-493-4443",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.