Individual provider Active NPI

Renee C Casey, M.D.

  • Pediatrics Physician
  • Milford, CT
National Provider Identifier
1376734343
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
1.048749 Issued in CT
Practice address
88 Noble Ave Ste 101
Milford, CT 06460-4738
Phone
(203) 874-2800
NPI assigned
Aug 6, 2007
Last updated
Jul 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1.048749 CT Primary

Addresses

Primary practice location

88 Noble Ave Ste 101
Milford, CT 06460-4738

Mailing address

31 Riverside Dr
Milford, CT 06461-3917
Phone (203) 687-6311

Other practice location 1

3180 Main St
Bridgeport, CT 06606-4237
Phone (203) 371-7111

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150410000062 CT Practitioner - Pediatric Medicine 4284952847 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1.048749CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optimus Health Care Inc CurrentSince Dec 14, 2014 Accepting new patients
Preferred Pediatrics Pediatrics Past Accepting new patients

Locations

471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864

982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1376734343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 RIVERSIDE DR",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064613917",
            "telephone_number": "203-687-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 NOBLE AVE STE 101",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064604738",
            "telephone_number": "203-874-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3180 Main St",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066064237",
            "country_code": "US",
            "telephone_number": "203-371-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASEY",
        "first_name": "RENEE",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "1.048749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.