NPIMap

Organization Active NPI

Plastic Surgery of Greater Hartford LLC

  • Plastic Surgery Physician
  • Bloomfield, CT
National Provider Identifier
1659569416
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
034529 Issued in CT
Legal business name
PLASTIC SURGERY OF GREATER HARTFORD LLC
Practice address
1 Barnard LN
Suite 102
Bloomfield, CT 06002-2481
Phone
(860) 243-1889
Fax
(860) 243-5733
NPI assigned
Oct 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Authorized official

Name
Jonathan S Schreiber, MDNPI 1528065984
Title
Owner
Phone
(860) 243-1889

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 034529 CT Primary

Addresses

Primary practice location

1 Barnard LN
Suite 102
Bloomfield, CT 06002-2481

Mailing address

1 Barnard LN
Suite 102
Bloomfield, CT 06002-2481
Phone (860) 243-1889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101101001186 CT Part B Supplier - Clinic/Group Practice 0143317339 Receives reassigned benefits from 2 practitioners
Practice locations: Bloomfield, CT

National Provider Directory

National Provider Directory

Locations

1 Barnard Ln
Bloomfield, CT 06002
Phone (860) 243-1889

1 Barnard Ln
Ste 102
Bloomfield, CT 06002
Phone (860) 243-1889

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1659569416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BARNARD LN",
            "address_2": "SUITE 102",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022481",
            "telephone_number": "860-243-1889",
            "fax_number": "860-243-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNARD LN",
            "address_2": "SUITE 102",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022481",
            "telephone_number": "860-243-1889",
            "fax_number": "860-243-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY OF GREATER HARTFORD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "SCHREIBER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-243-1889",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "CT",
            "license": "034529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.