Individual provider Active NPI

Shieva L Ghofrany, M.D.

  • Obstetrics & Gynecology Physician
  • Stamford, CT
National Provider Identifier
1538267356
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
014579 Issued in CT
Practice address
1275 Summer St
Suite A2
Stamford, CT 06905-5359
Phone
(203) 353-9099
Fax
(203) 353-9699
NPI assigned
Sep 20, 2006
Last updated
Feb 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 041579 CT
Obstetrics & Gynecology Physician 207V00000X 014579 CT Primary

Addresses

Primary practice location

1275 Summer St
Suite A2
Stamford, CT 06905-5359

Mailing address

1275 Summer St
Suite A2
Stamford, CT 06905-5359
Phone (203) 353-9099

Other identifiers 1

IdentifierTypeStateIssuer
041579OtherCTLICENSE

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
I20160212000537 CT Practitioner - Obstetrics/Gynecology 3971759499 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041579CTMDSpecialist
014579CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Obstetrics and Gynecology PC Specialist CurrentSince Aug 15, 2012 Accepting new patients
Shieva Ghofrany MD LLC Obstetrics & Gynecology Current Accepting new patients

Locations

1275 Summer St
Ste A2
Stamford, CT 06905
Phone (203) 353-9099

999 Summer St
Stamford, CT 06905
Phone (203) 353-9099

999 Summer St
Ste 401
Stamford, CT 06905
Phone (203) 353-9099

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1538267356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 SUMMER ST",
            "address_2": "SUITE A2",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055359",
            "telephone_number": "203-353-9099",
            "fax_number": "203-353-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 SUMMER ST",
            "address_2": "SUITE A2",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055359",
            "telephone_number": "203-353-9099",
            "fax_number": "203-353-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOFRANY",
        "first_name": "SHIEVA",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "041579",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "014579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "041579",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.