Individual provider Active NPI

Leor Zedek, M.D.

  • Hospitalist Physician
  • Waterbury, CT
National Provider Identifier
1427000538
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
042267 Issued in CT
Practice address
64 Robbins St
6TH Floor
Waterbury, CT 06708-2613
Phone
(203) 573-6263
Fax
(203) 573-6030
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 042267 CT
Hospitalist Physician 208M00000X 042267 CT Primary

Addresses

Primary practice location

64 Robbins St
6TH Floor
Waterbury, CT 06708-2613

Mailing address

1625 Straits Tpke
Suite #301
Middlebury, CT 06762-1836
Phone (203) 573-9512

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
I20040824000871 CT Practitioner - Internal Medicine 9133193220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

18 Haynes St
Uppr Level
Manchester, CT 06040-4111
Phone (860) 649-7557

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042267CTMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect CT Medical Foundation, Inc. Family Medicine CurrentSince Sep 1, 2016 Accepting new patients
Domenic W. Casablanca, M.D., P.C. Past Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

1625 Straits Tpke
Ste 201
Middlebury, CT 06762
Phone (203) 573-9512

1625 Straits Tpke
Ste 211
Middlebury, CT 06762
Phone (203) 573-9512

1625 Straits Tpke
Ste 301
Middlebury, CT 06762
Phone (203) 573-7281

1625 Straits Tpke
Ste 302
Middlebury, CT 06762
Phone (203) 759-0666

64 Robbins St
Fl 6
Waterbury, CT 06708
Phone (203) 573-6263

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

455 Chase Pkwy
Waterbury, CT 06708
Phone (203) 573-1435

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1427000538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TPKE",
            "address_2": "SUITE #301",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-573-9512",
            "fax_number": "203-568-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 ROBBINS ST",
            "address_2": "6TH FLOOR",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082613",
            "telephone_number": "203-573-6263",
            "fax_number": "203-573-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEDEK",
        "first_name": "LEOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "042267",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "042267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.