Organization Active NPI

Crossroads Orthopaedic Subspecialists LLC

  • Orthopaedic Surgery Physician
  • Waterford, CT
National Provider Identifier
1669492583
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
CROSSROADS ORTHOPAEDIC SUBSPECIALISTS LLC
Practice address
196 Parkway S Ste 201
Waterford, CT 06385-1234
Phone
(860) 442-5361
Fax
(860) 437-0318
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Authorized official

Name
Mr. David Stahelski
Title
Practice Administrater
Phone
(860) 442-5361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

196 Parkway S Ste 201
Waterford, CT 06385-1234

Mailing address

196 Parkway S Ste 201
Waterford, CT 06385-1234
Phone (860) 442-5361

National Provider Directory

National Provider Directory

Locations

196 Parkway S
Ste 201
Waterford, CT 06385
Phone (860) 440-0688

Practitioners & affiliated clinicians

Practitioners 1

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": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372032000000",
    "number": "1669492583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S STE 201",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851234",
            "telephone_number": "860-442-5361",
            "fax_number": "860-437-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S STE 201",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851234",
            "telephone_number": "860-442-5361",
            "fax_number": "860-437-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS ORTHOPAEDIC SUBSPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2013-06-24",
        "status": "A",
        "authorized_official_last_name": "STAHELSKI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATER",
        "authorized_official_telephone_number": "860-442-5361",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.