Alexis Gopal, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

034613 Issued in CT

Practice address

30 Quaker Farms Rd Ste 1
Southbury, CT 06488-2732

Phone

(203) 262-9300

Fax

(855) 719-2198

NPI assigned

Aug 10, 2012

Last updated

Oct 30, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Griffin Faculty Physicians, Inc.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Derby, CT
  • NPI 1598755605

  Internal Medicine

  Medicare reassignment NPD
• Iraj Rahmati MD PC

  • Ophthalmology Physician
  • New Milford, CT
  • NPI 1033424940
  NPD (past)
• New Milford Medical Group, LLC

  • Internal Medicine Physician
  • New Milford, CT
  • NPI 1356403323
  NPD (past)
• Nuvance Health Medical Practice CT, Inc.

  • Internal Medicine Physician
  • Danbury, CT
  • NPI 1407898117
  NPD (past)

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

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1477800241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MAPLE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181328",
            "telephone_number": "203-732-1330",
            "fax_number": "203-732-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 QUAKER FARMS RD STE 1",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882732",
            "telephone_number": "203-262-9300",
            "fax_number": "855-719-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOPAL",
        "first_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-10",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "034613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "034613",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Georgette, CRNA
• Rachel Gerowe, PT
• Gregory David Gersten, MD
• Reba Goodrow, APRN
• Charlotte Gooler, OT
• Raafat Gorgy, DO
• Kathryn Grabowski, LCSW
• Grade a Shoprite of Southbury LLC (Shoprite Pharmacy)
• Artavia Graham
• Jeffrey Robert Grasson, DPT

• Internal Medicine Physician in Southbury, CT
• Providers in Southbury, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.

Verify at the official NPI Registry.