Surgical Specialists PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

024773 Issued in CT

Legal business name

SURGICAL SPECIALISTS PC

Practice address

134 Grandview Ave
Suite 209
Waterbury, CT 06708-2507

Phone

(203) 755-6666

Fax

(203) 573-6735

NPI assigned

Mar 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jayakara Shetty, MD

Title

President

Phone

(203) 755-6666

Specialties & licenses 1

Addresses

Other identifiers 10

Locations

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257206400000",
    "number": "1497874945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 GRANDVIEW AVE",
            "address_2": "SUITE 209",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082507",
            "telephone_number": "203-755-6666",
            "fax_number": "203-573-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 GRANDVIEW AVE",
            "address_2": "SUITE 209",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082507",
            "telephone_number": "203-755-6666",
            "fax_number": "203-573-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2009-11-03",
        "status": "A",
        "authorized_official_last_name": "SHETTY",
        "authorized_official_first_name": "JAYAKARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-755-6666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CT",
            "license": "024773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020045404",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0R0463",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USH",
            "identifier": "556517",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "010024773CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0199318",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "130555",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001247733",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "024773",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "130555",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTHPLAN",
            "identifier": "NHS039",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gertrude Ellen Super, M.A.
• Taiya Supranovich, LMSW
• Janet Suquilanda
• Surgi-Center Anesthesiologists, P.C
• Surgical Associates of Waterbury, P.C.
• Arvind Suri
• Lila Sussman
• Griffin Suter, PHARMD
• Lori Sweeney
• Leslie S Swiderski, RN,LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2009; 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.