NPIMap

Organization Active NPI

Bridgeport Monroe Pediatric GRP., PC

  • Pediatrics Physician
  • Bridgeport, CT
National Provider Identifier
1427135698
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
23440 Issued in CT
Legal business name
BRIDGEPORT MONROE PEDIATRIC GRP., PC
Practice address
2475 North Ave
Bridgeport, CT 06604-2337
Phone
(203) 367-6050
Fax
(203) 366-1367
NPI assigned
Nov 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Pedro Malave, M.D.NPI 1912987702
Title
President
Phone
(203) 367-6050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 23440 CT Primary

Addresses

Primary practice location

2475 North Ave
Bridgeport, CT 06604-2337

Mailing address

2475 North Ave
Bridgeport, CT 06604-2337
Phone (203) 367-6050

Other names 1

  • Newtown Monroe Pediatric Grp Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427135698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 NORTH AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066042337",
            "telephone_number": "203-367-6050",
            "fax_number": "203-366-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 NORTH AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066042337",
            "telephone_number": "203-367-6050",
            "fax_number": "203-366-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEPORT MONROE PEDIATRIC GRP., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MALAVE",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-367-6050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "23440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newtown Monroe Pediatric Grp",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.