Edward J McDermott, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20822 Issued in CT

Practice address

235 Lestertown Rd
Groton, CT 06340-2808

Phone

(860) 445-7478

NPI assigned

Nov 28, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Connecticut Post Acute Medical Services 1 PC

  • Hospitalist Physician
  • Derby, CT
  • NPI 1558890467
  Medicare reassignment NPD
• CS Pacs 3 Northeast, LLC

  • Hospitalist Physician
  • Frederick, MD
  • NPI 1093598898

  CT

  Medicare reassignment NPD
• Ma Pacs 2 PC

  • Hospitalist Physician
  • Chelsea, MA
  • NPI 1265918791

  CT

  Medicare reassignment NPD
• Edward McDermott MD

  • Nurse Practitioner
  • New London, CT
  • NPI 1518090976
  NPD (past) Authorized official
• Edward McDermott, MD

  • Internal Medicine Physician
  • New London, CT
  • NPI 1629109467
  NPD (past) Authorized official

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1356324008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204726",
            "telephone_number": "860-460-3236",
            "fax_number": "860-442-7270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 LESTERTOWN RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063402808",
            "telephone_number": "860-445-7478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "276 Montauk Ave",
            "address_2": "Ste R",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "CT",
            "postal_code": "063204727",
            "country_code": "US",
            "telephone_number": "860-447-1475",
            "fax_number": "860-447-8598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "20822",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "20822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "030963",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001208222",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "010020822CT03",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Mattiucci, RPH
• Joseph John May
• Douglas McAdams, M.D.
• Stephanie Ann McBurnett, RDN
• David J McCormick, PAC
• Jeffrey Lynn McGregor, IDC
• Patricia McIvor, M.D.
• Dorothy Chapkovich McLaughlin, BS
• Gordon F McMichael III, HM1, USN
• Matthew Cody McNeely, IDC

• Internal Medicine Physician in Groton, CT
• Providers in Groton, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.