NPIMap

Individual provider Active NPI

Stephen Pool, M.D.

  • Emergency Medicine Physician
  • Bridgeport, CT
National Provider Identifier
1558388181
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
211543 Issued in NY
Practice address
2800 Main St
Bridgeport, CT 06606-4201
Phone
(203) 576-5177
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 211543 NY Primary
Emergency Medicine Physician 207P00000X 047951 CT

Addresses

Primary practice location

2800 Main St
Bridgeport, CT 06606-4201

Mailing address

561 10TH Ave Apt 46D
New York, NY 10036-3061
Phone (917) 355-3553

Other identifiers 2

IdentifierTypeStateIssuer
036106535MedicaidIL
02081583MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
047951CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phelps Memorial Hospital Association Emergency Medicine Past Accepting new patients
Medrite Medical Care PC PastSince Oct 5, 2011 Accepting new patients
Beth Israel Medical Center Emergency Medicine Past Accepting new patients
Neighborhood Health, Inc. Emergency Medicine Past Accepting new patients
Illiana Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Illiana Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Bimc Faculty Practice Emergency Medicine Past Accepting new patients
St. Vincent'S Midtown Hospital Past Accepting new patients
Phelps Memorial Hospital Association Past Accepting new patients

Organizations & group practices 9

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1558388181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 10TH AVE APT 46D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100363061",
            "telephone_number": "917-355-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "203-576-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOL",
        "first_name": "STEPHEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "211543",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "047951",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036106535",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02081583",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.