Daisy H Bang, MD
Individual provider Active NPI Rheumatology Physician · Shelton, CT
NPI 1356579460 · NPPES record last updated Oct 7, 2024
Key facts
- NPI
- 1356579460
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Rheumatology Physician 207RR0500X
- License
- 54070 (CT)
- Practice address
- 2 Ivy Brook Rd Ste 115
Shelton, CT 06484-6416 - Phone
- (203) 954-0080
- Fax
- (203) 954-0084
- NPI assigned
- Jun 26, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Rheumatology
- Education
- Tufts University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Griffin Faculty Physicians Inc
Practice addresses (Care Compare)
2 Ivy Brook Rd
Suite 115
Shelton, CT 06484-6416
Phone (203) 924-5540
Hospital & facility affiliations
- Griffin Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150812008678 | CT | Practitioner - Rheumatology | 0648435487 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 195213 | PA | MD | Internal Medicine Physician |
| 54070 | CT | MD | Rheumatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Griffin Faculty Physicians, Inc. | Internal Medicine | Current |
Accepting new patients |
Locations
130 Division St
Derby, CT 06418
Phone (203) 732-1330
2 Ivy Brook Rd
Ste 115
Shelton, CT 06484
Phone (203) 954-0080
Interoperability endpoints
- daisy.bang.1@1323.direct.athenahealth.com
- dbang4057708@nychhc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 195213 | PA | |
| Rheumatology Physician | 207RR0500X | 54070 | CT | Yes |
Addresses
Primary practice location
2 Ivy Brook Rd Ste 115
Shelton, CT 06484-6416
Mailing address
2 Ivy Brook Rd Ste 115
Shelton, CT 06484-6416
Phone (203) 954-0080
Other providers in Shelton, CT
- Beth A Balko
- Jillian Ingrid Ball
- Dammy Bamisile
- Foluke R Bamisile
- Grace Dolores Bandow
- Joseph William Barbar
- Vanessa L Barber
- Elaine Barclay
- Dorothy Ann Barr-Reseska
- Alexis Barran
All providers in Shelton, CT · Rheumatology 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 Oct 7, 2024. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.