Organization Active NPI

Cheshire Endocrinology & Internal Medicine PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Cheshire, CT
National Provider Identifier
1467759753
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
019485 Issued in CT
Legal business name
CHESHIRE ENDOCRINOLOGY & INTERNAL MEDICINE PC
Practice address
577 S Main St
Cheshire, CT 06410-3146
Phone
(203) 272-1619
Fax
(203) 272-1610
NPI assigned
Feb 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Authorized official

Name
Dr. Richard D Kayne, MDNPI 1982709630
Title
President
Phone
(203) 272-1619

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 019485 CT
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X 019485 CT Primary

Addresses

Primary practice location

577 S Main St
Cheshire, CT 06410-3146

Mailing address

577 S Main St
Cheshire, CT 06410-3146
Phone (203) 272-1619

Other identifiers 8

IdentifierTypeStateIssuer
01001948CT07OtherCTANTHEM BLUE CROSS BLUE SHIELD
OV7469OtherCTHEALTH NET
0959728009OtherCTCIGNA HEALTH
1051367OtherAETNA PC
P918440OtherCTOXFORD HEALTH
710126OtherCTCONNECTICARE
2203200OtherCTAETNA ENDOCRINOLOGY SPECIALIST
110200086OtherCTMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110418000166 CT Part B Supplier - Clinic/Group Practice 8123202025 Receives reassigned benefits from 1 practitioner
Practice locations: Cheshire, CT

National Provider Directory

National Provider Directory

Locations

577 S Main St
Cheshire, CT 06410
Phone (203) 272-1619

Practitioners & affiliated clinicians

Practitioners 1

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": "1298332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298332800000",
    "number": "1467759753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103146",
            "telephone_number": "203-272-1619",
            "fax_number": "203-272-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103146",
            "telephone_number": "203-272-1619",
            "fax_number": "203-272-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESHIRE ENDOCRINOLOGY & INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-22",
        "last_updated": "2011-02-22",
        "status": "A",
        "authorized_official_last_name": "KAYNE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-272-1619",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "019485",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CT",
            "license": "019485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SHIELD",
            "identifier": "01001948CT07",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "OV7469",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH",
            "identifier": "0959728009",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PC",
            "identifier": "1051367",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH",
            "identifier": "P918440",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "710126",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ENDOCRINOLOGY SPECIALIST",
            "identifier": "2203200",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110200086",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2011; 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.