NPIMap

Individual provider Active NPI

Igor Malitsky, CPED

  • Orthotist
  • Cromwell, CT
National Provider Identifier
1497801666
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OrthotistTaxonomy code 222Z00000X
License
20361 Issued in CT
Practice address
51 Shunpike Rd Ste 41
Cromwell, CT 06416-2497
Phone
(860) 635-7653
Fax
(860) 635-2080
NPI assigned
Jan 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X 20361 CT Primary

Addresses

Primary practice location

51 Shunpike Rd Ste 41
Cromwell, CT 06416-2497

Mailing address

51 Shunpike Rd Ste 41
Cromwell, CT 06416-2497
Phone (860) 635-7653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20361CTMDOrthotist

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Orthotics, LLC Past Accepting new patients
New England Orthotic & Prosthetics Systems, LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1497801666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 SHUNPIKE RD STE 41",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162497",
            "telephone_number": "860-635-7653",
            "fax_number": "860-635-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 SHUNPIKE RD STE 41",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162497",
            "telephone_number": "860-635-7653",
            "fax_number": "860-635-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALITSKY",
        "first_name": "IGOR",
        "name_prefix": "Mr.",
        "credential": "CPED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-28",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "CT",
            "license": "20361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cromwell, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.