Agnes Czibulka, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

037603 Issued in CT

Practice address

31 Broadway
North Haven, CT 06473-2304

Phone

(203) 234-1324

Fax

(203) 239-3047

NPI assigned

Aug 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Otolaryngology

Education

Other, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ear, Nose and Throat Medical and Surgical Group, LLCGroup PAC ID 5698831212, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FEBFCA

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

• Ear Nose & Throat Medical and Surgical Group, LLC

  • Otolaryngology Physician
  • North Haven, CT
  • NPI 1790854651
  Medicare reassignment Care Compare group
• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  Medicare reassignment NPD
• Ear Nose & Throat Medical and Surgical Group, LLC

  • Nurse Practitioner
  • New Haven, CT
  • NPI 1679835086
  NPD (past) Authorized official
• Mill Hill Medical Consultants Inc

  • Pain Medicine (Anesthesiology) Physician
  • Greenwich, CT
  • NPI 1144230954
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  Care Compare affiliation
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1578778726
  Care Compare affiliation

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407969686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 BROADWAY",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732304",
            "telephone_number": "203-234-1324",
            "fax_number": "203-239-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 BROADWAY",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732304",
            "telephone_number": "203-234-1324",
            "fax_number": "203-239-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZIBULKA",
        "first_name": "AGNES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CT",
            "license": "037603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ralph Anthony Criscuolo, DC CC SP
• CT Comprehensive Neurologic Management, LLC
• CT Youth Resources
• Lauren Cusano, APRN
• Matthew Richard Cyr
• D and M Comfort and Care, LLC
• D'Agostino Family Dental, LLC
• Louis D'Amora, LCSW
• Matthew Michael D'Angelo, DPM
• Rachelle D'Angelo, APRN

• Otolaryngology Physician in North Haven, CT
• Providers in North Haven, CT by specialty
• Otolaryngology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.