Individual provider Active NPI

Nicholas V. Polifroni, M.D.

  • Orthopaedic Surgery Physician
  • Norwalk, CT
National Provider Identifier
1508865288
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
023383 Issued in CT
Practice address
761 Main Ave
Suite 115
Norwalk, CT 06851-1080
Phone
(203) 845-2200
Fax
(203) 847-1940
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 023383 CT Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 023383 CT

Addresses

Primary practice location

761 Main Ave
Suite 115
Norwalk, CT 06851-1080

Mailing address

761 Main Ave
Suite 115
Norwalk, CT 06851-1080
Phone (203) 845-2200

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
I20101006000649 CT Practitioner - Orthopedic Surgery 2769519107 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023383CTMDOrthopaedic Surgery Physician
023393CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norwalk Hospital Association CurrentSince Jan 1, 2012 Accepting new patients
Norwalk Hospital Association CurrentSince Jan 1, 2012 Accepting new patients

Locations

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

761 Main Ave
Ste 115
Norwalk, CT 06851
Phone (203) 545-2200

40 Cross St
Ste 300
Norwalk, CT 06851
Phone (203) 229-2000

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": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1508865288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE",
            "address_2": "SUITE 115",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-845-2200",
            "fax_number": "203-847-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE",
            "address_2": "SUITE 115",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-845-2200",
            "fax_number": "203-847-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIFRONI",
        "first_name": "NICHOLAS",
        "middle_name": "V.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CT",
            "license": "023383",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CT",
            "license": "023383",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.