Active NPI
Diabetes and Endocrinology of Northwestern Connecticut
- Endocrinology, Diabetes & Metabolism Physician
- Torrington, CT
National Provider Identifier
1407944689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- Legal business name
- DIABETES AND ENDOCRINOLOGY OF NORTHWESTERN CONNECTICUT
- Practice address
- 780 Litchfield St
Torrington, CT 06790-6268 - Phone
- (860) 496-2198
- Fax
- (860) 489-2482
- NPI assigned
- Oct 11, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Egils Knuts Bogdanovics, M.D.
- Title
- Owner
- Phone
- (860) 496-2198
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | Primary |
Addresses
Primary practice location
780 Litchfield St
Torrington, CT 06790-6268
Mailing address
780 Litchfield St
Torrington, CT 06790-6268
Phone (860) 496-2198
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7133354 | Other | CT | AETNA CLAIMS ID |
| 4311104 | Other | CT | AETNA EDI ID |
| 3000 | Other | CT | NEIC SITE ID, NSF BAO-7 |
| 001312660 | Medicaid | CT |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1352419200000",
"number": "1407944689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "780 LITCHFIELD ST",
"city": "TORRINGTON",
"state": "CT",
"postal_code": "067906268",
"telephone_number": "860-496-2198",
"fax_number": "860-489-2482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "780 LITCHFIELD ST",
"city": "TORRINGTON",
"state": "CT",
"postal_code": "067906268",
"telephone_number": "860-496-2198",
"fax_number": "860-489-2482"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DIABETES AND ENDOCRINOLOGY OF NORTHWESTERN CONNECTICUT",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-11",
"last_updated": "2012-11-09",
"status": "A",
"authorized_official_last_name": "BOGDANOVICS",
"authorized_official_first_name": "EGILS",
"authorized_official_middle_name": "KNUTS",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "860-496-2198",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA CLAIMS ID",
"identifier": "7133354",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA EDI ID",
"identifier": "4311104",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIC SITE ID, NSF BAO-7",
"identifier": "3000",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001312660",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Torrington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.