Individual provider Active NPI

Nino Gigauri, M.D.

  • Internal Medicine Physician
  • Hartford, CT
National Provider Identifier
1487036802
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
57059 Issued in CT
Practice address
114 Woodlawn St
Hartford, CT 06110
Phone
(860) 714-4000
NPI assigned
Jun 22, 2015
Reactivated
May 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57059 CT Primary

Addresses

Primary practice location

114 Woodlawn St
Hartford, CT 06110

Mailing address

267 Grant St
Bridgeport Hospital Department of Medicine
Bridgeport, CT 06610

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ngigauri370066@direct.stfranciscare.org Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180627002599 CT Practitioner - Internal Medicine 4183970528 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4741

Hospital & facility affiliations

  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Jun 20, 2022 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince Jun 20, 2022 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Jul 9, 2018 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Jul 9, 2018 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

20 York St
Unit CB2041
New Haven, CT 06510
Phone (203) 688-4741

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: ngigauri192963@direct.ynhh.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1487036802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "address_2": "BRIDGEPORT HOSPITAL DEPARTMENT OF MEDICINE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAWN ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06110",
            "telephone_number": "860-714-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIGAURI",
        "first_name": "NINO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "deactivation_date": "2016-01-20",
        "reactivation_date": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "57059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ngigauri370066@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Trinity Health of New England",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "114 Woodland St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061051208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.