Stephen Conner Widman, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

030739 Issued in CT

Practice address

455 Chase Pkwy
Waterbury, CT 06708-3352

Phone

(203) 573-1435

Fax

(203) 755-7433

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 9

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Wake Forest University School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiology Associates of Greater Waterbury, LLCGroup PAC ID 7113100868, 6 clinicians

Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Waterbury Hospital Hospital, Waterbury, CT, CCN 070005
• Saint Mary'S Hospital Hospital, Waterbury, CT, CCN 070016
• Griffin Hospital Hospital, Derby, CT, CCN 070031
• Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
• John Dempsey Hospital of the University of Connect Hospital, Farmington, CT, CCN 070036

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephen.widman.1@8999.direct.athenahealth.com

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.

• Cardiology Associates of Greater Waterbury LLC

  • Cardiovascular Disease Physician
  • Waterbury, CT
  • NPI 1407159833
  Medicare reassignment Care Compare group NPD
• Prospect CT Medical Foundation, Inc.

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1144677568
  Medicare reassignment Care Compare group NPD
• Prospect Waterbury, Inc.

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1477902641
  Medicare reassignment NPD
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812

  Cardiovascular Disease

  Medicare reassignment NPD
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

• John Dempsey Hospital at Solnit - South Campus

  • Psychiatric Hospital Unit
  • Middletown, CT
  • NPI 1154263713
  Care Compare affiliation
• Prospect Waterbury, Inc.

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1477902641
  Care Compare affiliation
• Saint Mary'S Hospital, Inc.

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1760426969
  Care Compare affiliation
• State of Connecticut

  • General Acute Care Hospital
  • Farmington, CT
  • NPI 1669466561
  Care Compare affiliation
• The Griffin Hospital

  • General Acute Care Hospital
  • Derby, CT
  • NPI 1184639973
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1578778726
  Care Compare affiliation

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1346278512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 CHASE PKWY",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083352",
            "telephone_number": "203-573-1435",
            "fax_number": "203-755-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 CHASE PKWY",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083352",
            "telephone_number": "203-573-1435",
            "fax_number": "203-755-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDMAN",
        "first_name": "STEPHEN",
        "middle_name": "CONNER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "030739",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CT",
            "license": "030739",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "CT",
            "license": "030739",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET OF NORTHEAST",
            "identifier": "0R0351",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001307398",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH PLANS",
            "identifier": "010130739",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P381955",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110036141",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "030739",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH LANS",
            "identifier": "4127784",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346278512",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC & BS",
            "identifier": "010030739CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Venesa Shanique White
• Cornieta Whitfield, APRN
• Megan Whitman
• Quentin R Whitmore, PATHOLOGY ASSISTANT
• Cornelius W Wickersham, M.D.
• Kelly Ann Wilber, APRN
• Cameron Wilcox
• Dawn N Wilda, MSW
• Dustin K Wilde, DMD
• Brittney Wilkes, LPC

• Interventional Cardiology Physician in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Interventional Cardiology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.