Individual provider Active NPI

Timothy B Ehrlich II, M.D.

  • Surgery Physician
  • Trumbull, CT
National Provider Identifier
1568411973
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0400945 Issued in CT
Practice address
115 Technology Drive
Suite C100
Trumbull, CT 06611
Phone
(203) 899-0744
Fax
(203) 268-6779
NPI assigned
May 10, 2006
Last updated
Dec 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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 0400945 CT Primary

Addresses

Primary practice location

115 Technology Drive
Suite C100
Trumbull, CT 06611

Mailing address

12 Sherwood Farms Lane
Westport, CT 06880
Phone (203) 226-5667

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
0400945CTMDSurgery Physician

Organizations & group practices 1

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1568411973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SHERWOOD FARMS LANE",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "06880",
            "telephone_number": "203-226-5667",
            "fax_number": "203-557-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 TECHNOLOGY DRIVE",
            "address_2": "SUITE C100",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "06611",
            "telephone_number": "203-899-0744",
            "fax_number": "203-268-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRLICH",
        "first_name": "TIMOTHY",
        "middle_name": "B",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "0400945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.