Waterbury Podiatry Consultants

Primary specialty

PodiatristTaxonomy code 213E00000X

License

000447 Issued in CT

Legal business name

WATERBURY PODIATRY CONSULTANTS

Practice address

171 Grandview Ave
Suite 104
Waterbury, CT 06708-2517

Phone

(203) 753-2048

Fax

(203) 753-5891

NPI assigned

Nov 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Marc Richard Bernbach, DPM

Title

Dr. / Owner

Phone

(203) 753-2048

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel Kellner, DPM

  • Foot & Ankle Surgery Podiatrist
  • Waterbury, CT
  • NPI 1386164077
  Medicare reassignment Care Compare group NPD
• Steven Francis Massucci, D.P.M

  • Sports Medicine Podiatrist
  • Providence, RI
  • NPI 1821523143

  CT

  Medicare reassignment Care Compare group NPD
• Leo M Veleas, D.P.M.

  • Foot Surgery Podiatrist
  • Southington, CT
  • NPI 1053593863
  NPD (past)

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1447430467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 GRANDVIEW AVE",
            "address_2": "SUITE 104",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082517",
            "telephone_number": "203-753-2048",
            "fax_number": "203-753-5891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 GRANDVIEW AVE",
            "address_2": "SUITE 104",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082517",
            "telephone_number": "203-753-2048",
            "fax_number": "203-753-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERBURY PODIATRY CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "BERNBACH",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "DR. / OWNER",
        "authorized_official_telephone_number": "203-753-2048",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "000447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "409031",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Waterbury Medical Equip Supply Inc
• Waterbury Orthopaedic Associates P C
• Waterbury Orthopaedic Associates PC
• Waterbury Pharmacy LLC
• Waterbury Pharmacy LLC
• Waterbury Psychiatric Associates, P.C.
• Waterbury Pulmonary Associates
• Waterbury Radiation Oncology Associates, PC
• Melanie A. Watkins-Griffin, LCSW
• Frederick J. Watson, M.D.

• Podiatrist in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.