Individual provider Active NPI

Forugh Homayounrooz, MD

  • Internal Medicine Physician
  • Bridgeport, CT
National Provider Identifier
1346276912
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
037716 Issued in CT
Practice address
2800 Main St
Bridgeport, CT 06606-4201
Phone
(203) 576-6133
Fax
(203) 576-6133
NPI assigned
Jun 24, 2006
Last updated
Jan 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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 037716 CT Primary

Addresses

Primary practice location

2800 Main St
Bridgeport, CT 06606-4201

Mailing address

2800 Main St
Bridgeport, CT 06606-4201
Phone (203) 576-6133

Other identifiers 1

IdentifierTypeStateIssuer
001377169MedicaidCT

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041123000668 CT Practitioner - Internal MedicinePractitioner - Hospitalist 8123083755 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimus Health Care IncGroup PAC ID 9335051580, 79 clinicians

Practice addresses (Care Compare)

471 Barnum Ave
Bridgeport, CT 06608-2409
Phone (203) 576-3885

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stamford Health Medical Group Inc Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
Optimus Health Care Inc CurrentSince Sep 1, 2017 Accepting new patients
Hospital of Saint Raphael Past Accepting new patients

Locations

471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864

982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260

1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925

1351 Washington Blvd
Stamford, CT 06902
Phone (203) 276-7464

5 High Ridge Park
Ste 103
Stamford, CT 06905
Phone (203) 276-4644

Interoperability endpoints

  • Direct secure messaging: fhomayounrooz24231@stamfordhealth.direct-ci.com
  • Direct secure messaging: fhomayounrooz571791@direct.ynhh.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1346276912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "203-576-6133",
            "fax_number": "203-581-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "203-576-6133",
            "fax_number": "203-576-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMAYOUNROOZ",
        "first_name": "FORUGH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "037716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001377169",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.