Individual provider Active NPI

Boris Mayzler, D.O.,M.D.

  • Family Medicine Physician
  • Stamford, CT
National Provider Identifier
1417038753
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
CT038982 Issued in CT
Practice address
144 Morgan St
Suite1
Stamford, CT 06905-5433
Phone
(203) 961-0063
Fax
(203) 961-0064
NPI assigned
Oct 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X CT038982 CT Primary

Addresses

Primary practice location

144 Morgan St
Suite1
Stamford, CT 06905-5433

Mailing address

144 Morgan St
Suite1
Stamford, CT 06905-5433
Phone (203) 961-0063

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
I20041025001027 CT Practitioner - Family Practice 0840251559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians

Practice addresses (Care Compare)

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

70 Mill River St
Stamford, CT 06902-3725
Phone (203) 961-0063

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CT038982CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boris Mayzler DO LLC Family Medicine CurrentSince Feb 1, 2002 Accepting new patients
The Charlotte Hungerford Hospital Past Accepting new patients

Locations

144 Morgan St
Ste 1
Stamford, CT 06905
Phone (203) 252-2463

70 Mill River St
Stamford, CT 06902
Phone (203) 323-8989

70 Mill River St
Ste UL1
Stamford, CT 06902
Phone (203) 961-0063

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417038753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 MORGAN ST",
            "address_2": "SUITE1",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055433",
            "telephone_number": "203-961-0063",
            "fax_number": "203-961-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 MORGAN ST",
            "address_2": "SUITE1",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055433",
            "telephone_number": "203-961-0063",
            "fax_number": "203-961-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYZLER",
        "first_name": "BORIS",
        "name_prefix": "Dr.",
        "credential": "D.O.,M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "CT038982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.