Individual provider Active NPI

Kanwardeep S Arora, MD

  • Internal Medicine Physician
  • Derby, CT
National Provider Identifier
1508026428
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
51094 Issued in CT
Practice address
130 Division St
Derby, CT 06418-1326
Phone
(203) 732-1330
Fax
(203) 732-1332
NPI assigned
Jun 13, 2008
Last updated
Oct 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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 51094 CT Primary

Addresses

Primary practice location

130 Division St
Derby, CT 06418-1326

Mailing address

67 Maple Ave
Derby, CT 06418-1328
Phone (203) 732-1330

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
I20151026000616 CT Practitioner - Internal Medicine 4486728516 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

18 Haynes St
Uppr Level
Manchester, CT 06040-4111
Phone (860) 649-7557

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51094CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect CT Medical Foundation, Inc. Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
Griffin Faculty Physicians, Inc. Internal Medicine CurrentSince Nov 14, 2016 Accepting new patients
Gaylord Hospital, Inc. CurrentSince Jun 5, 2023 Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

130 Division St
Derby, CT 06418
Phone (203) 732-1330

67 Maple Ave
Derby, CT 06418
Phone (203) 732-0699

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

1625 Straits Tpke
Middlebury, CT 06762
Phone (203) 759-0666

1625 Straits Tpke
Ste 201
Middlebury, CT 06762
Phone (203) 573-9512

50 Gaylord Farm Rd
Wallingford, CT 06492
Phone (203) 679-3553

160 Robbins St
Waterbury, CT 06708
Phone (203) 573-7284

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

Organizations & group practices 3

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

Hospital & facility affiliations 1

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": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1508026428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MAPLE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181328",
            "telephone_number": "203-732-1330",
            "fax_number": "203-732-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 DIVISION ST",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181326",
            "telephone_number": "203-732-1330",
            "fax_number": "203-732-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARORA",
        "first_name": "KANWARDEEP",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-13",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "51094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, CT

Sources for this page

Verify at the official NPI Registry.