NPIMap

Individual provider Active NPI

David Schwindt

  • Adolescent Medicine (Internal Medicine) Physician
  • Mystic, CT
National Provider Identifier
1366489536
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
0471821 Issued in CT
Practice address
23 Clara Drive
Ste 204
Mystic, CT 06355
Phone
(860) 572-0010
Fax
(860) 536-2799
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 5

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

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of New Mexico School of Medicine
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ptsma Inc 173 clinicians

Practice addresses (Care Compare)

23 Clara Dr
Mystic, CT 06355-1959

37 S Broad St
Pawcatuck, CT 06379-7909
Phone (860) 495-1919

Hospital & facility affiliations

  • Westerly Hospital Hospital, Westerly, RI, CCN 410013
  • Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031218000797 CT Practitioner - Internal MedicinePractitioner - Pediatric Medicine 9335045707 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0471821CTMDAdolescent Medicine (Internal Medicine) Physician
11245RIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Felipe Health Clinic Past Accepting new patients
Santo Domingo Health Clinic Past Accepting new patients

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 0471821 CT Primary
Pediatrics Physician 208000000X 11245 RI
Pediatrics Physician 208000000X 0471821 CT

Addresses

NPPES NPI Registry

Primary practice location

23 Clara Drive
Ste 204
Mystic, CT 06355

Mailing address

23 Clara Drive
Ste 204
Mystic, CT 06355
Phone (860) 572-0010

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
1418210MedicaidCT
DSS1272MedicaidRI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 6, 2007.

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1366489536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CLARA DRIVE",
            "address_2": "STE 204",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-572-0010",
            "fax_number": "860-536-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CLARA DRIVE",
            "address_2": "STE 204",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-572-0010",
            "fax_number": "860-536-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWINDT",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "CT",
            "license": "0471821",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "11245",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "0471821",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1418210",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DSS1272",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mystic, CT

Sources for this page

Verify at the official NPI Registry.