NPIMap

Organization Active NPI

Bastion Medical Practice of New Jersey PC

  • Urology Physician
  • Farmington, CT
National Provider Identifier
1598529802
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
BASTION MEDICAL PRACTICE OF NEW JERSEY PC
Practice address
400 Farmington Ave
Farmington, CT 06032-1913
Phone
(650) 610-1617
NPI assigned
Feb 7, 2024
Last updated
Feb 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Authorized official

Name
Dr. Vasanth Kainkaryam, MD
Title
President
Phone
(786) 220-0003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

400 Farmington Ave
Farmington, CT 06032-1913

Mailing address

400 Farmington Ave
Farmington, CT 06032-1913
Phone (650) 610-1617

National Provider Directory

National Provider Directory

Locations

400 Farmington Ave
Farmington, CT 06032
Phone (650) 610-1617

Practitioners & affiliated clinicians

Practitioners 11

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": "1707264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1598529802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321913",
            "telephone_number": "650-610-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321913",
            "telephone_number": "650-610-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASTION MEDICAL PRACTICE OF NEW JERSEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "KAINKARYAM",
        "authorized_official_first_name": "VASANTH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-220-0003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.