Raymond Joseph Ippolito, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

016865 Issued in CT

Practice address

420 East Main Street
BLDG 2 Unit 5
Branford, CT 06405

Phone

(203) 481-6722

Fax

(203) 483-2074

NPI assigned

Sep 20, 2006

Last updated

Jan 11, 2012By the provider in NPPES

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1487752903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 EAST MAIN STREET",
            "address_2": "BLDG 2 UNIT 5",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "06405",
            "telephone_number": "203-481-6722",
            "fax_number": "203-483-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 EAST MAIN STREET",
            "address_2": "BLDG 2 UNIT 5",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "06405",
            "telephone_number": "203-481-6722",
            "fax_number": "203-483-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IPPOLITO",
        "first_name": "RAYMOND",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "016865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010016865CT01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0Q1189",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "709727",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne Marie Iennaco, APRN
• Christopher Dunbar Illick, MD
• Yoon Im, LCSW
• Inner Peace Creations, LLC
• Internal Medicine of East Haven PC
• Nord Scott Isacson, D.C.
• J.T. Bristol, M.D., LLC
• Justice Jackson, LMSW
• Bruce A Jacobsen, PT
• Kathleen M Jacobsen, RPT

• Surgery Physician in Branford, CT
• Providers in Branford, CT by specialty
• Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.