NPIMap

Individual provider Active NPI

Hector Rodolfo Pun, MD

  • Gastroenterology Physician
  • Waterbury, CT
National Provider Identifier
1447304944
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
024176 Issued in CT
Practice address
134 Grandview Ave
Suite 202
Waterbury, CT 06708-2507
Phone
(203) 756-7788
Fax
(203) 754-1254
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 024176 CT Primary

Addresses

Primary practice location

134 Grandview Ave
Suite 202
Waterbury, CT 06708-2507

Mailing address

134 Grandview Ave
Suite 202
Waterbury, CT 06708-2507
Phone (203) 756-7788

Other identifiers 1

IdentifierTypeStateIssuer
1241769MedicaidCT

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
I20110326000055 CT Practitioner - Internal MedicinePractitioner - Gastroenterology 9537340625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

64 Robbins St
Waterbury, CT 06708-2613
Phone (203) 573-6263

Hospital & facility affiliations

  • Uconn Health Community Network Home Health, Inc. Home health agency, Watertown, CT, CCN 077085
  • Hartford Healthcare at Home Home health agency, East Hartford, CT, CCN 077041
  • Waterbury Hospital Hospital, Waterbury, CT, CCN 070005
  • Saint Mary'S Hospital Hospital, Waterbury, CT, CCN 070016
  • Griffin Hospital Hospital, Derby, CT, CCN 070031
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Apple Rehab Watertown Nursing home, Watertown, CT, CCN 075181

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024176CTMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect CT Medical Foundation, Inc. Gastroenterology CurrentSince Dec 1, 2019 Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

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

134 Grandview Ave
Waterbury, CT 06708
Phone (203) 573-6270

134 Grandview Ave
Ste 204
Waterbury, CT 06708
Phone (203) 756-7788

134 Grandview Ave
Ste 202
Waterbury, CT 06708
Phone (203) 756-7788

134 Grandview Ave
#202204
Waterbury, CT 06708

Interoperability endpoints

  • Direct secure messaging: hectorpun@amggw.allscriptsdirect.net

Organizations & group practices 1

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 8

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1447304944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 GRANDVIEW AVE",
            "address_2": "SUITE 202",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082507",
            "telephone_number": "203-756-7788",
            "fax_number": "203-754-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 GRANDVIEW AVE",
            "address_2": "SUITE 202",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082507",
            "telephone_number": "203-756-7788",
            "fax_number": "203-754-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUN",
        "first_name": "HECTOR",
        "middle_name": "RODOLFO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "024176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1241769",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.