Pounds Medical Weight Loss Transformation PC
Organization Active NPI Obesity Medicine (Obstetrics & Gynecology) Physician · West Hartford, CT
NPI 1306283718 · NPPES record last updated Aug 25, 2015
Key facts
- NPI
- 1306283718
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obesity Medicine (Obstetrics & Gynecology) Physician 207VB0002X
- License
- 042274 (CT)
- Legal business name
- POUNDS MEDICAL WEIGHT LOSS TRANSFORMATION PC
- Practice address
- 125 Lasalle Rd
Ste 208
West Hartford, CT 06107-2322 - Phone
- (860) 906-1732
- Fax
- (860) 906-1269
- NPI assigned
- May 24, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Charles Cavo, D.O.
- Title
- Owner
- Phone
- (860) 906-1732
Practitioners 22
-
Charles A Cavo, D.O.
-
Kristin Marie Kuchyt, APRN, FNP-C
-
Maegan Wing, APRN
-
Emily Woods, APRN
-
Michelle L Cavo, PA
-
Collette Martin, PA-C
-
Elizabeth Fracchia, APRN
-
Stephanie Gort, PA-C
-
Magdalena Lukaszewicz, PA-C
-
Michael Joseph Ouellette, MS, RDN, CDN
-
Jami Pliego, RD
-
Linda Armistead, RN, CMSRN
-
Sean Gorey, CNS, CDN
-
Rebecca McKeown, MS, RD
-
Erin E Queno, RD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131105001229 | CT | Part B Supplier - Clinic/Group Practice | 5991930661 |
Receives reassigned benefits from 11 practitioners Practice locations: Glastonbury, CT; Southington, CT; West Hartford, CT |
National Provider Directory
Locations
480 Naubuc Ave
Glastonbury, CT 06033
Phone (860) 494-2400
125 Lasalle Rd
West Hartford, CT 06107
Phone (860) 381-9233
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obesity Medicine (Obstetrics & Gynecology) Physician |
207VB0002X | 042274 | CT | Yes |
| Pediatrics Physician |
208000000X | 042274 | CT | |
| Nurse Practitioner |
363L00000X | 042274 | CT |
Addresses
Primary practice location
125 Lasalle Rd
Ste 208
West Hartford, CT 06107-2322
Mailing address
125 Lasalle Rd
Ste 208
West Hartford, CT 06107-2322
Phone (860) 906-1732
Other providers in West Hartford, CT
- Carol Jean Porter
- Colleen Lahart Porth
- Positive Mind(Set) Counseling, LLC
- Posture Corp.
- Ira Potashner
- Pounds, Medical Weight Loss Transformation, PC
- Margaret Powell
- Chastian Powers
- Practitioners Advancing Healthcare
- Precision Toxicology, LLC
All providers in West Hartford, CT · Obesity Medicine (Obstetrics & Gynecology) Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.