Shoreline Medical Associates LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SHORELINE MEDICAL ASSOCIATES LLC

Practice address

1353 Boston Post Rd
Madison, CT 06443-3445

Phone

(203) 245-4933

Fax

(203) 245-4399

NPI assigned

Jun 15, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer P Swenson, M.D.

Title

Physician

Phone

(203) 245-4933

Specialties & licenses 2

Addresses

Other identifiers 3

Practitioners 1

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

• Aimee J Criscuolo Beck, P.A.

  • Medical Physician Assistant
  • Groton, CT
  • NPI 1124122650
  NPD (past)

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1497750798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 BOSTON POST RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 BOSTON POST RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433445",
            "telephone_number": "203-245-4933",
            "fax_number": "203-245-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "SWENSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "203-245-4933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "006159",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001222280",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001378422",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001421916",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shari a. Roguski DC, LLC
• Ryan Shook, LCSW
• Shore Wellness CT
• Shoreline Anesthesia Associates LLC
• Shoreline Chiropractic Center, LLC
• Shoreline Pediatrics & Adolescent Medicine, P.C.
• Shoreline Psychological
• Shoreline Psychotherapy Crisis and Consultation Center LLC
• Shoreline Speech Therapy
• Jessica Lyn Shultis

• Specialist in Madison, CT
• Providers in Madison, CT by specialty
• Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.