Individual provider Active NPI

Stephen Pollani, PA-C

  • Medical Physician Assistant
  • Hamden, CT
National Provider Identifier
1609331933
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PENDING Issued in CT
Practice address
2165 Dixwell Ave
Hamden, CT 06514-2116
Phone
(203) 248-2727
NPI assigned
Jan 31, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PENDING CT Primary
Medical Physician Assistant 363AM0700X 021571 NY

Addresses

Primary practice location

2165 Dixwell Ave
Hamden, CT 06514-2116

Mailing address

121 Fan Hill Rd
Monroe, CT 06468-1830
Phone (203) 556-9395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190306003127 NY Practitioner - Physician Assistant 5395084420 Reassigns benefits to 1 organization
I20190404001001 CT Practitioner - Physician Assistant 5395084420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Medical Associates, LLCGroup PAC ID 7214107515, 113 clinicians
Urgent Care Medical of New York LLCGroup PAC ID 5890071443, 40 clinicians

Practice addresses (Care Compare)

266 S Main St
Newtown, CT 06470-6706
Phone (860) 650-3848

31 Old Route 7
Brookfield, CT 06804-1711
Phone (860) 650-3848

346 Main Ave
Norwalk, CT 06851-1592
Phone (860) 650-3848

80 Route 6
Suite 704 705
Baldwin Place, NY 10505-1026
Phone (860) 650-3848

900 Main St S
Suite 100
Southbury, CT 06488-4213
Phone (860) 650-3848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PENDINGCTMDGeneral Practice Dentistry
021571NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
WRK Ventures, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: spollani21220@direct.ynhh.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1609331933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 FAN HILL RD",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064681830",
            "telephone_number": "203-556-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065142116",
            "telephone_number": "203-248-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLANI",
        "first_name": "STEPHEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "PENDING",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "021571",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.