Active NPI
Lawrence Rifkin, MD
- Pediatrics Physician
- Bloomfield, CT
National Provider Identifier
1629091798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 032317
- Practice address
- 580 Cottage Grove Rd Ste 103
Bloomfield, CT 06002-3088 - Phone
- (860) 243-5225
- Fax
- (860) 769-6757
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 032317 | CT | Primary |
| Pediatric Adolescent Medicine Physician | 2080A0000X | 032317 | CT |
Addresses
Primary practice location
580 Cottage Grove Rd Ste 103
Bloomfield, CT 06002-3088
Mailing address
291 Stanley Dr
Glastonbury, CT 06033-2621
Phone (860) 918-1275
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001323170 | Medicaid | CT | |
| 010032317CT03 | Other | CT | ANTHEM BLUE SHIELD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lawrence.rifkin.1@27673.direct.athenahealth.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150403000525 | CT | Order and Referring Only - Pediatric Medicine | 0446578330 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032317 | CT | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collins Medical Associates 2 PC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- lawrence.rifkin.1@27673.direct.athenahealth.com
Organizations & group practices 1
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": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722470400000",
"number": "1629091798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "291 STANLEY DR",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060332621",
"telephone_number": "860-918-1275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "580 COTTAGE GROVE RD STE 103",
"city": "BLOOMFIELD",
"state": "CT",
"postal_code": "060023088",
"telephone_number": "860-243-5225",
"fax_number": "860-769-6757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIFKIN",
"first_name": "LAWRENCE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2024-08-01",
"certification_date": "2024-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CT",
"license": "032317",
"primary": true
},
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "CT",
"license": "032317",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001323170",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE SHIELD",
"identifier": "010032317CT03",
"state": "CT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lawrence.rifkin.1@27673.direct.athenahealth.com",
"affiliation": "N",
"address_1": "580 Cottage Grove Rd Ste 103",
"city": "Bloomfield",
"state": "CT",
"country_code": "US",
"postal_code": "060023088",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bloomfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.