NPIMap

Organization Active NPI

Orthopaedic & Neurosurgery Specialists, PLLC

  • Orthopaedic Surgery Physician
  • Westbrook, CT
National Provider Identifier
1376137471
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPAEDIC & NEUROSURGERY SPECIALISTS, PLLC
Practice address
5 Pequot Park Road
Suite 202
Westbrook, CT 06498-2856
Phone
(860) 399-0245
Fax
(860) 894-1892
NPI assigned
Mar 1, 2021
Last updated
Feb 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Authorized official

Name
Maribeth Chach
Title
Owner
Phone
(203) 869-1145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

5 Pequot Park Road
Suite 202
Westbrook, CT 06498-2856

Mailing address

5 High Ridge Park FL 2
Stamford, CT 06905-1332
Phone (203) 869-1145

Other identifiers 1

IdentifierTypeStateIssuer
004395217MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210426002480 CT DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 5294628947 Practice locations: Westbrook, CT

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Orthopaedic Neurosurgery21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

5 Pequot Park Rd
Ste 202
Westbrook, CT 06498
Phone (860) 399-0245

NPI Registry JSON

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1376137471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HIGH RIDGE PARK FL 2",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069051332",
            "telephone_number": "203-869-1145",
            "fax_number": "203-618-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PEQUOT PARK ROAD",
            "address_2": "SUITE 202",
            "city": "WESTBROOK",
            "state": "CT",
            "postal_code": "064982856",
            "telephone_number": "860-399-0245",
            "fax_number": "860-894-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC & NEUROSURGERY SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "CHACH",
        "authorized_official_first_name": "MARIBETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-869-1145"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004395217",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbrook, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.