Active NPI
Radiology Associates of Waterbury, PC
- Diagnostic Radiology Physician
- Waterbury, CT
National Provider Identifier
1568522985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 16335
- Legal business name
- RADIOLOGY ASSOCIATES OF WATERBURY, PC
- Practice address
- 80 Phoenix Ave
Waterbury, CT 06702-1418 - Phone
- (203) 573-1800
- NPI assigned
- Dec 8, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Michael M Shapiro, M.D.
- Title
- President
- Phone
- (203) 573-1800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 16335 | CT | Primary |
Addresses
Primary practice location
80 Phoenix Ave
Waterbury, CT 06702-1418
Mailing address
80 Phoenix Ave
Waterbury, CT 06702-1418
Phone (203) 573-1800
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ANC1144 | Other | CT | OXFORD HEALTH PLAN |
| 129350 | Other | CT | WELLCARE |
| 50RADASSCCT01 | Other | CT | BLUE SHIELD |
| 35321959 | Other | CT | AIMI |
| 56010016335CT2 | Other | CT | BLUE SHIELD NATIONAL ACCT |
National Provider Directory
National Provider DirectoryLocations
80 Phoenix Ave
Waterbury, CT 06702
Phone (203) 573-1800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1568522985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 PHOENIX AVE",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067021418",
"telephone_number": "203-573-1800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 PHOENIX AVE",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067021418",
"telephone_number": "203-573-1800"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RADIOLOGY ASSOCIATES OF WATERBURY, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-08",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SHAPIRO",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "203-573-1800",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": "CT",
"license": "16335",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLAN",
"identifier": "ANC1144",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "129350",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "50RADASSCCT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AIMI",
"identifier": "35321959",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD NATIONAL ACCT",
"identifier": "56010016335CT2",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.