Individual provider Active NPI

Paul A Shapiro, MD

  • Gastroenterology Physician
  • Bloomfield, CT
National Provider Identifier
1386748994
Registry record updated Apr 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
018756 Issued in CT
Practice address
6 Northwestern Dr
Suite 302
Bloomfield, CT 06002-3463
Phone
(860) 243-5600
Fax
(860) 243-3047
NPI assigned
Sep 12, 2006
Last updated
Apr 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 018756 CT Primary

Addresses

Primary practice location

6 Northwestern Dr
Suite 302
Bloomfield, CT 06002-3463

Mailing address

2139 Silas Deane Hwy
Rocky Hill, CT 06067-2336
Phone (860) 257-4131

Other identifiers 1

IdentifierTypeStateIssuer
001187566MedicaidCT

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
I20051212000358 CT Practitioner - GastroenterologyPractitioner - Internal Medicine 1456372374 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Gi PLLC Gastroenterology CurrentSince Apr 1, 2007 Accepting new patients

Locations

6 Northwestern Dr
Ste 302
Bloomfield, CT 06002
Phone (860) 243-5600

85 Seymour St
Ste 1000
Hartford, CT 06106
Phone (860) 246-2571

30 Waterchase Dr
Rocky Hill, CT 06067
Phone (860) 257-4131

Organizations & group practices 1

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304035200000",
    "number": "1386748994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 SILAS DEANE HWY",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060672336",
            "telephone_number": "860-257-4131",
            "fax_number": "860-257-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 NORTHWESTERN DR",
            "address_2": "SUITE 302",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023463",
            "telephone_number": "860-243-5600",
            "fax_number": "860-243-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "PAUL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2011-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "018756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001187566",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

Verify at the official NPI Registry.