Active NPI
Poonam Thakore, M.D.
- Neonatal-Perinatal Medicine Physician
- Bridgeport, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 036159517
- Practice address
- 2800 Main St
Bridgeport, CT 06606-4201 - Phone
- (475) 210-5310
- Fax
- (475) 210-5784
- NPI assigned
- Mar 22, 2016
- Last updated
- Aug 5, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 62497 | CT | |
| Pediatrics Physician | 208000000X | 036159517 | IL | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 036159517 | IL | Primary |
Addresses
Primary practice location
2800 Main St
Bridgeport, CT 06606-4201
Mailing address
1290 Silas Deane Hwy
HHC-Cvo
Wethersfield, CT 06109-4337
Phone (860) 972-5507
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pthakore57444@sih.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62497 | CT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group Specialists, PLLC | Current | Accepting new patients | |
| Hartford Healthcare Medical Group Specialists LLC | Current | Accepting new patients | |
| Connecticut Children's Specialty Group, Inc. | Pediatrics | Current | Accepting new patients |
| Connecticut Children's Specialty Group, Inc. | Pediatrics | Current | Accepting new patients |
| Southern Illinois Medical Services, NFP | Current | Accepting new patients |
Locations
2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366
24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118
10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619
10 Columbus Blvd
Fl 4
Hartford, CT 06106
Phone (860) 837-5560
100 Retreat Ave
Fl 5
Hartford, CT 06106
Phone (860) 837-5206
282 Washington St
Hartford, CT 06106
Phone (860) 545-8950
80 Seymour St
Fl 5
Hartford, CT 06106
Phone (860) 545-8950
71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981
435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340
100 Grand St
New Britain, CT 06052
Phone (860) 224-5011
34 Maple St
Norwalk, CT 06850
Phone (203) 852-2000
326 Washington St
Norwich, CT 06360
Phone (860) 701-0140
1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300
405 W Jackson St
Carbondale, IL 62901
Interoperability endpoints
- poonam.thakore@xdr.hhchealthdirect.org
- pthakore46362@connecticutchildrens.direct-ci.com
- pthakore57444@sih.direct-ci.com
Organizations & group practices 5
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.
-
- Pediatrics Physician
- Hartford, CT
- NPI 1669448882
-
- Surgery Physician
- Hartford, CT
- NPI 1023584216
-
dba SIH Medical Group
- Internal Medicine Physician
- Carbondale, IL
- NPI 1770656837
-
- Ophthalmology Physician
- Glastonbury, CT
- NPI 1568056984
Pediatrics
-
- Customized Equipment (DME)
- Groton, CT
- NPI 1295367068
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754352000000",
"number": "1447612148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1290 SILAS DEANE HWY",
"address_2": "HHC-CVO",
"city": "WETHERSFIELD",
"state": "CT",
"postal_code": "061094337",
"telephone_number": "860-972-5507",
"fax_number": "860-972-7040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066064201",
"telephone_number": "475-210-5310",
"fax_number": "475-210-5784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAKORE",
"first_name": "POONAM",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-22",
"last_updated": "2025-08-05",
"certification_date": "2025-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CT",
"license": "62497",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036159517",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "IL",
"license": "036159517",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pthakore57444@sih.direct-ci.com",
"affiliation": "N",
"address_1": "405 W Jackson St",
"city": "Carbondale",
"state": "IL",
"country_code": "US",
"postal_code": "629011462",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bridgeport, CT
- Tetyana Pohorletska Andassociates, Inc.
- Aaron Matthew Charles Tevay, CRNA, APRN
- Prithvi Thadikonda, PHARMD
- Kunj Y Thakkar
- Nisarg Thakker, MB,BS
- The Backstroke, LLC
- The Child and Family Guidance Center
- The Child and Family Guidance Center, Inc.
- The Davis & Brooks Family Agency
- The Hearing Center of Bridgeport, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.