NPIMap

Individual provider Active NPI

Philip J Karanian, MD

  • Internal Medicine Physician
  • West Hartford, CT
National Provider Identifier
1437136132
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
029480 Issued in CT
Practice address
20 Isham Rd
Suite 150
West Hartford, CT 06107-2204
Phone
(860) 522-6118
Fax
(860) 246-0122
NPI assigned
Dec 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 029480 CT Primary

Addresses

Primary practice location

20 Isham Rd
Suite 150
West Hartford, CT 06107-2204

Mailing address

30 Jordan LN
Wethersfield, CT 06109-1278
Phone (860) 263-0253

Other identifiers 3

IdentifierTypeStateIssuer
001294800MedicaidCT
010029480CT01OtherCTBCBS
029480OtherCTMEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pkaranian16505@direct.stfranciscare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091203000370 CT Practitioner - Internal Medicine 5799874558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Healthcare, PCGroup PAC ID 6709787930, 67 clinicians

Practice addresses (Care Compare)

20 Isham Rd
West Hartford, CT 06107-2204

30 Jordan LN
Wethersfield, CT 06109-1278
Phone (860) 263-0253

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029480CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare, PC Internal Medicine CurrentSince Jan 1, 1998 Accepting new patients
Prime Healthcare (Sleep Lab) CurrentSince Jan 1, 1998 Accepting new patients

Locations

20 Isham Rd
Ste 150
West Hartford, CT 06107
Phone (860) 522-6118

30 Jordan Ln
Wethersfield, CT 06109
Phone (860) 263-0253

Interoperability endpoints

  • Direct secure messaging: philip.karanian.1@31712.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Autumn Lake Healthcare at West HartfordWest Hartford, CT, CCN 075407 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 28, 2023
Nov 28, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • 1 Emily Way Opco LLC

    dba Autumn Lake Healthcare at West Hartford

    • Skilled Nursing Facility
    • West Hartford, CT
    • NPI 1972380921

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

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 9

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1437136132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 JORDAN LN",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091278",
            "telephone_number": "860-263-0253",
            "fax_number": "860-263-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ISHAM RD",
            "address_2": "SUITE 150",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072204",
            "telephone_number": "860-522-6118",
            "fax_number": "860-246-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARANIAN",
        "first_name": "PHILIP",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2023-03-07",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "029480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001294800",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010029480CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "029480",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pkaranian16505@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Prime Healthcare Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "20 Isham Rd",
            "address_2": "Suite 150",
            "city": "West Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061072204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.