Individual provider Active NPI

Joan Tekula, DPM

  • Podiatrist
  • Southbury, CT
National Provider Identifier
1417948118
Registry record updated Feb 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000494 Issued in CT
Practice address
2 Pomperaug Office Park
Suite 106
Southbury, CT 06488-2288
Phone
(203) 264-0200
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 000494 CT Primary

Addresses

Primary practice location

2 Pomperaug Office Park
Suite 106
Southbury, CT 06488-2288

Mailing address

2 Pomperaug Office Park
Suite 106
Southbury, CT 06488-2288
Phone (203) 264-0200

Other names 1

  • Joan Bogen Former name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040216001020 CT Practitioner - Podiatry 9739074170 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000494CTMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health and Wellness Center of Greater Torrington Inc CurrentSince Oct 1, 2020 Accepting new patients
Community Health and Wellness Center of Greater Torrington Inc CurrentSince Oct 1, 2020 Accepting new patients
Peter T Labarbera, DPM PastSince Sep 1, 2014 Accepting new patients
Community Health & Wellness Center of Greater Torrington Past Accepting new patients
Barbara a. Kilkenny, DPM Podiatrist Past Accepting new patients

Locations

469 Migeon Ave
Torrington, CT 06790
Phone (860) 387-0439

10 Center St
Winsted, CT 06098
Phone (860) 238-4211

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266624000000",
    "number": "1417948118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 POMPERAUG OFFICE PARK",
            "address_2": "SUITE 106",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882288",
            "telephone_number": "203-264-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 POMPERAUG OFFICE PARK",
            "address_2": "SUITE 106",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882288",
            "telephone_number": "203-264-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKULA",
        "first_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2010-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "000494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOAN",
            "last_name": "BOGEN",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Southbury, CT

Sources for this page

Verify at the official NPI Registry.