Organization Active NPI

Gary a. Letts, M.D. LLC

Doing business as Corium Diagnostics

  • Dermatopathology (Pathology) Physician
  • Norwalk, CT
National Provider Identifier
1568691079
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
043041 Issued in CT
Legal business name
GARY A. LETTS, M.D. LLC
Doing business as
Corium Diagnostics
Practice address
148 East Ave Ste 2D
Norwalk, CT 06851-5726
Phone
(203) 348-7546
Fax
(203) 348-7547
NPI assigned
Jul 6, 2009
Last updated
Aug 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Authorized official

Name
Dr. Gary A Letts, MDNPI 1124235437
Title
President and Medical Director
Phone
(203) 832-3737

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X 043041 CT Primary

Addresses

Primary practice location

148 East Ave Ste 2D
Norwalk, CT 06851-5726

Mailing address

148 East Ave Ste 2D
Norwalk, CT 06851-5726
Phone (203) 348-7546

Other names 1

  • CORIUM DIAGNOSTICS Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL office@coriumdiagnostics.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100806000083 CT Part B Supplier - Clinic/Group Practice 6709919038 Receives reassigned benefits from 1 practitioner
Practice locations: Norwalk, CT

National Provider Directory

National Provider Directory

Locations

106 Noroton Ave
#201
Darien, CT 06820

148 East Ave
Ste 2D
Norwalk, CT 06851
Phone (203) 348-7546

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1568691079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 EAST AVE STE 2D",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515726",
            "telephone_number": "203-348-7546",
            "fax_number": "203-348-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 EAST AVE STE 2D",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515726",
            "telephone_number": "203-348-7546",
            "fax_number": "203-348-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY A. LETTS, M.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-06",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "LETTS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT AND MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "203-832-3737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CT",
            "license": "043041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "office@coriumdiagnostics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "148 East Ave Ste 2D",
            "city": "Norwalk",
            "state": "CT",
            "country_code": "US",
            "postal_code": "068515726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CORIUM DIAGNOSTICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.