Individual provider Active NPI

Shady Macaron, MD

  • Surgery Physician
  • Waterbury, CT
National Provider Identifier
1528241080
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
045869 Issued in CT
Practice address
56 Franklin St
Waterbury, CT 06706-1253
Phone
(203) 709-6000
NPI assigned
Dec 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 045869 CT Primary

Addresses

Primary practice location

56 Franklin St
Waterbury, CT 06706-1253

Mailing address

56 Franklin St
Waterbury, CT 06706-1253
Phone (203) 709-6000

Other identifiers 3

IdentifierTypeStateIssuer
045869OtherCTCONNECTICARE
PENDINGOtherCTRR MEDICARE
969161OtherAETNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smacaron44412@direct.stfranciscare.org Direct

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
I20080707000611 CT Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology)Practitioner - Peripheral Vascular DiseasePractitioner - Vascular SurgeryPractitioner - Critical Care (Intensivists)Practitioner - Surgical Oncology 1355413451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Colorectal Surgery (Proctology), Critical Care (Intensivists), Peripheral Vascular Disease, Surgical Oncology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

56 Franklin St
Waterbury, CT 06706-1253
Phone (203) 709-6000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)20
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux17
Varicose vein removal1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
045869CTMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

687 Straits Tpke
Ste 2A
Middlebury, CT 06762
Phone (203) 575-1811

687 Straits Tpke
Ste 1B
Middlebury, CT 06762
Phone (203) 598-0235

590 Middlebury Rd
Ste A
Middlebury, CT 06762
Phone (203) 577-3700

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

Interoperability endpoints

  • Direct secure messaging: smacaron2389903@direct.trinity-health.org
  • Direct secure messaging: smacaron@direct.wtbyhosp.org

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, 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": "1196985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1528241080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061253",
            "telephone_number": "203-709-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061253",
            "telephone_number": "203-709-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACARON",
        "first_name": "SHADY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-07",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "045869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "045869",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "PENDING",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "969161",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smacaron44412@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "56 Franklin St",
            "city": "Waterbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "067061253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.