NPIMap

Individual provider Active NPI

Leonardi Koliani, M.D.

  • Internal Medicine Physician
  • Middlebury, CT
National Provider Identifier
1619995677
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
027381 Issued in CT
Practice address
1625 Straits Tpke
Suite #110
Middlebury, CT 06762-1836
Phone
(203) 758-8107
Fax
(203) 568-2925
NPI assigned
Jul 18, 2006
Last updated
Feb 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 027381 CT Primary

Addresses

Primary practice location

1625 Straits Tpke
Suite #110
Middlebury, CT 06762-1836

Mailing address

1625 Straits Tpke
Suite #110
Middlebury, CT 06762-1836
Phone (203) 758-8107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040203000605 CT Practitioner - Internal Medicine 0244123487 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

1625 Straits Tpke
Middlebury, CT 06762-1836
Phone (203) 758-8107

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect CT Medical Foundation, Inc. Internal Medicine CurrentSince Oct 1, 2016 Accepting new patients
Seasons Medical Group of Connecticut PC CurrentSince Mar 10, 2019 Accepting new patients
WRK Ventures, LLC PastSince Mar 3, 2010 Accepting new patients
Naugatuck Valley Computerized Imaging Past Accepting new patients
Diagnostic Imaging of Southbury Past Accepting new patients
Diagnostic Imaging Associates LLC Past Accepting new patients
Regional Physician Services Connecticut PC Past Accepting new patients
Seasons Hospice & Palliative Care of Connecticut, LLC Past Accepting new patients
Alliance Medical Group of Greater Waterbury PC Internal Medicine Past Accepting new patients
Regional Physician Services, CT, P.C Internal Medicine Past Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

1579 Straits Tpke
Ste 1E
Middlebury, CT 06762
Phone (203) 490-1000

1625 Straits Tpke
Ste 110
Middlebury, CT 06762
Phone (203) 758-8107

6400 Shafer Ct
Ste 700
Rosemont, IL 60018

Interoperability endpoints

  • Direct secure messaging: leonardikoliani@amggw.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Complete Care at Glendale LLCNaugatuck, CT, CCN 075240 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2021
Sep 1, 2021
Accentcare Hospice & Palliative Care of ConnecticutMiddlebury, CT, CCN 071539 Hospice W-2 Managing Employee Jan 14, 2016

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1619995677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TPKE",
            "address_2": "SUITE #110",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-758-8107",
            "fax_number": "203-568-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TPKE",
            "address_2": "SUITE #110",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-758-8107",
            "fax_number": "203-568-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLIANI",
        "first_name": "LEONARDI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "027381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, CT

Sources for this page

Verify at the official NPI Registry.