NPIMap

Individual provider Active NPI

Kenneth F Marici, MD

  • Internal Medicine Physician
  • New Milford, CT
National Provider Identifier
1568414993
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036520 Issued in CT
Practice address
2 Old Park Lane Rd Ste 1
New Milford, CT 06776-2561
Phone
(860) 354-5511
Fax
(860) 350-3122
NPI assigned
May 16, 2006
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036520 CT Primary

Addresses

Primary practice location

2 Old Park Lane Rd Ste 1
New Milford, CT 06776-2561

Mailing address

2 Old Park Lane Rd Ste 1
New Milford, CT 06776-2561
Phone (860) 354-5511

Other identifiers 1

IdentifierTypeStateIssuer
001365205MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031203000075 CT Practitioner - Internal Medicine 4284539388 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kenneth F. Marici, MD, PCGroup PAC ID 7012091754, 2 clinicians
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

11 Prospect Hill Rd
New Milford, CT 06776-3695
Phone (860) 354-5511

22 Old Waterbury Rd
Southbury, CT 06488-3848
Phone (203) 262-4200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036520CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. Internal Medicine CurrentSince Sep 1, 2011 Accepting new patients
Kenneth F. Marici, MD, PC Internal Medicine CurrentSince Jul 6, 1998 Accepting new patients
New Milford Gastroenterology Associates, P.C. PastSince Aug 18, 2024 Accepting new patients
Alan Braverman, MD, PC Internal Medicine PastSince Jul 6, 1998 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

1 Booth House Ln
New Milford, CT 06776
Phone (860) 354-5511

2 Old Park Lane Rd
Ste 1
New Milford, CT 06776
Phone (860) 354-5511

21 Elm St
New Milford, CT 06776
Phone (860) 210-5000

22 Old Waterbury Rd
Southbury, CT 06488
Phone (203) 262-4200

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ridgefield Visiting Nurse AssociationRidgefield, CT, CCN 071545 Hospice W-2 Managing Employee Aug 9, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 8

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1568414993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 OLD PARK LANE RD STE 1",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067762561",
            "telephone_number": "860-354-5511",
            "fax_number": "860-350-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OLD PARK LANE RD STE 1",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067762561",
            "telephone_number": "860-354-5511",
            "fax_number": "860-350-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARICI",
        "first_name": "KENNETH",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "036520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001365205",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Milford, CT

Sources for this page

Verify at the official NPI Registry.