NPIMap

Organization Active NPI

Bristol Hospital Incorporated

  • General Acute Care Hospital
  • Bristol, CT
National Provider Identifier
1619901642
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0041 Issued in CT
Legal business name
BRISTOL HOSPITAL INCORPORATED
Practice address
41 Brewster Rd
Bristol, CT 06011-0977
Phone
(860) 585-3357
Fax
(860) 585-3179
NPI assigned
Jul 10, 2006
Last updated
Oct 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Authorized official

Name
Mr. Kurt Alan Barwis
Title
President and Ceo
Phone
(860) 585-3222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0041 CT Primary

Addresses

Primary practice location

41 Brewster Rd
Bristol, CT 06011-0977

Mailing address

41 Brewster Rd
PO Box 977
Bristol, CT 06011-0977
Phone (860) 585-3223

Other identifiers 8

IdentifierTypeStateIssuer
002OtherCTBLUE CROSS
996294OtherCTCONNECTICARE
H04722OtherCTOXFORD
I70013OtherCTHEALTHNET
4025193MedicaidCT
63122OtherCTAETNA US
4041901MedicaidCT
C001869OtherCTCHAMPUS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040426001533 CT Part B Supplier - Clinic/Group Practice 9739084096 Receives reassigned benefits from 30 practitioners
Practice locations: Bristol, CT
O20080813000239 CT Part A Provider - Hospital 9739084096 Practice locations: Bristol, CT; Terryville, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619901642. Details of each certification follow.

Hospital certification: CCN 070029

Legal name
BRISTOL HOSPITAL INCORPORATED
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Nov 2, 2016
Beds
134
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Feb 28, 1920 in CT
Enrollment address
41 Brewster Rd
Bristol, CT 60105161
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Bristol HospitalCCN 070029 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Bristol EMS3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

222 Main St
Bristol, CT 06010
Phone (860) 585-0837

594 Farmington Ave
Unit 42C
Bristol, CT 06010
Phone (860) 314-3477

641 Farmington Ave
Ste 5
Bristol, CT 06010
Phone (860) 314-3477

975 Farmington Ave
Ste 1
Bristol, CT 06010
Phone (860) 589-0114

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joseph Lockwood Individual Corporate DirectorBoard Member Apr 28, 2017
John Lodovico Individual Corporate OfficerSecretary / Treasurer Jan 17, 2008
Kurt a Barwis Individual Corporate DirectorPresident and Ceo Nov 8, 2006
Operational/Managerial ControlPresident and Ceo Aug 21, 2006 100%
Rupalini Rawal-Dhingra Individual Corporate DirectorBoard Member Oct 1, 2021
Bristol Hospital and Health Care Group Organization, Bristol, CT Corporation, Non-profit Operational/Managerial Control Dec 14, 1984 100%
Jennifer N McCallister Individual Corporate DirectorBoard Member Apr 3, 2019
Michele Normandin Individual Corporate DirectorBoard Member Jan 26, 2022
Glenn Heiser Individual Corporate OfficerBoard Member Jan 15, 2009
Michael Heimbach Individual Corporate DirectorBoard Member Mar 7, 2018
Louis Auletta Individual Corporate OfficerChairman Apr 24, 2024

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

Affiliated clinicians 288

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 288

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1619901642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 BREWSTER RD",
            "address_2": "PO BOX 977",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060110977",
            "telephone_number": "860-585-3223",
            "fax_number": "860-585-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 BREWSTER RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060110977",
            "telephone_number": "860-585-3357",
            "fax_number": "860-585-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL HOSPITAL INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "BARWIS",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "860-585-3222",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CT",
            "license": "0041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "002",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "996294",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "H04722",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "I70013",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4025193",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US",
            "identifier": "63122",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4041901",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "C001869",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.