NPIMap

Organization Active NPI

Pediatric Assoc of Conn PC

  • Pediatrics Physician
  • Waterbury, CT
National Provider Identifier
1376505859
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOC OF CONN PC
Practice address
160 Robbins Street
Waterbury, CT 06708
Phone
(203) 755-2999
Fax
(203) 755-6782
NPI assigned
Apr 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
Mr. Charles A Fischbein, MD
Title
President
Phone
(203) 755-2999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

160 Robbins Street
Waterbury, CT 06708

Mailing address

160 Robbins Street
Waterbury, CT 06708
Phone (203) 755-2999

Other identifiers 1

IdentifierTypeStateIssuer
0040534680MedicaidCT

National Provider Directory

National Provider Directory

Locations

1 Pomperaug Office Park
Southbury, CT 06488
Phone (203) 264-3130

1 Pomperaug Office Park
Ste 201
Southbury, CT 06488
Phone (203) 755-2999

229 Main St S
Southbury, CT 06488

1 Pomperaug Office Park
Ste 102
Southbury, CT 06488
Phone (203) 558-1143

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1376505859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 ROBBINS STREET",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06708",
            "telephone_number": "203-755-2999",
            "fax_number": "203-755-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ROBBINS STREET",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06708",
            "telephone_number": "203-755-2999",
            "fax_number": "203-755-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOC OF CONN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-03",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "FISCHBEIN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-755-2999",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0040534680",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.