Individual provider Active NPI

Sanjeev Rao, MD

  • Family Medicine Physician
  • Bridgeport, CT
National Provider Identifier
1548287378
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
039893 Issued in CT
Practice address
968 Fairfield Ave
Bridgeport, CT 06605-1116
Phone
(203) 330-6000
Fax
(203) 382-9425
NPI assigned
Jul 17, 2006
Last updated
Jan 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 039893 CT Primary
Internal Medicine Physician 207R00000X 039893 CT
Pediatrics Physician 208000000X 039893 CT

Addresses

Primary practice location

968 Fairfield Ave
Bridgeport, CT 06605-1116

Mailing address

75 Stone Ridge Way
Apt # 1E
Fairfield, CT 06824-5385
Phone (203) 366-4000

Other identifiers 1

IdentifierTypeStateIssuer
004236130MedicaidCT

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
I20040224000494 CT Practitioner - Internal MedicinePractitioner - Pediatric Medicine 1052207404 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bridgeport HospitalGroup PAC ID 2062312598, 134 clinicians
South-West Community Health Center IncGroup PAC ID 2466445200, 52 clinicians

Practice addresses (Care Compare)

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

46 Albion St
Bridgeport, CT 06605-2602
Phone (203) 332-3505

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.02 of 100Reported as group
Quality
87.5
Promoting interoperability
100
Improvement activities
40
Cost
77.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
039893CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeport Hospital CurrentSince May 20, 2013 Accepting new patients
South-West Community Health Center, Inc CurrentSince May 20, 2013 Accepting new patients
Bridgeport Hospital CurrentSince May 20, 2013 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

46 Albion St
Bridgeport, CT 06605
Phone (203) 332-3155

510 Clinton Ave
Bridgeport, CT 06605
Phone (203) 366-4000

968 Fairfield Ave
Bridgeport, CT 06605

Interoperability endpoints

  • Direct secure messaging: srao114247@direct.ynhh.org
  • Direct secure messaging: srao577639@direct.ochin.org

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 2

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1548287378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 STONE RIDGE WAY",
            "address_2": "APT # 1E",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245385",
            "telephone_number": "203-366-4000",
            "fax_number": "203-382-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "968 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051116",
            "telephone_number": "203-330-6000",
            "fax_number": "203-382-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "SANJEEV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "039893",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "039893",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "039893",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236130",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.