NPIMap

Organization Active NPI

Pain & Spine Specialists of Connecticut, LLC

  • Interventional Pain Medicine Physician
  • Danbury, CT
National Provider Identifier
1467588020
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
038785 Issued in CT
Legal business name
PAIN & SPINE SPECIALISTS OF CONNECTICUT, LLC
Practice address
67 Sandpit Rd
Suite 308
Danbury, CT 06810-4032
Phone
(203) 743-7246
Fax
(203) 792-3920
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Authorized official

Name
David C. Levi, M.D.
Title
President/Medical Director
Phone
(203) 743-7246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X 038785 CT Primary

Addresses

Primary practice location

67 Sandpit Rd
Suite 308
Danbury, CT 06810-4032

Mailing address

67 Sandpit Rd
Suite 308
Danbury, CT 06810-4032
Phone (203) 743-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070314000429 CT Part B Supplier - Clinic/Group Practice 0143323063 Receives reassigned benefits from 5 practitioners
Practice locations: Waterbury, CT; Trumbull, CT; New Milford, CT; Farmington, CT; Danbury, CT; Fairfield, CT

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

67 Sand Pit Rd
Ste 206
Danbury, CT 06810

220 Farmington Ave
Farmington, CT 06032
Phone (203) 883-0038

5520 Park Ave
Ste 303
Trumbull, CT 06611
Phone (203) 373-7330

5520 Park Ave
Ste WP2200
Trumbull, CT 06611
Phone 2037096000 ext. 3502

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478649600000",
    "number": "1467588020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 SANDPIT RD",
            "address_2": "SUITE 308",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068104032",
            "telephone_number": "203-743-7246",
            "fax_number": "203-792-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 SANDPIT RD",
            "address_2": "SUITE 308",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068104032",
            "telephone_number": "203-743-7246",
            "fax_number": "203-792-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN & SPINE SPECIALISTS OF CONNECTICUT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2016-11-09",
        "status": "A",
        "authorized_official_last_name": "LEVI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "203-743-7246",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CT",
            "license": "038785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.