NPIMap

Individual provider Active NPI

Pooia Fattahi, MD

  • Neurological Surgery Physician
  • Middlebury, CT
National Provider Identifier
1669625174
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
50832 Issued in CT
Practice address
1625 Straits Tpke
Suite 307 - Waterbury Neurology LLC
Middlebury, CT 06762-1836
Phone
(203) 758-2635
Fax
(203) 758-2571
NPI assigned
Oct 28, 2008
Last updated
Feb 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 50832 CT Primary

Addresses

Primary practice location

1625 Straits Tpke
Suite 307 - Waterbury Neurology LLC
Middlebury, CT 06762-1836

Mailing address

1625 Straits Tpke
Suite 307 - Waterbury Neurology LLC
Middlebury, CT 06762-1836
Phone (203) 758-2635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120809000253 CT Practitioner - Neurology 1850547795 Reassigns benefits to 7 organizations
I20241108001081 MA Practitioner - Neurology 1850547795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Wright State University Boonshoft School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

56 Franklin St
Waterbury, CT 06706-1253
Phone (203) 709-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50832CTMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC Neurological Surgery CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Aug 1, 2017 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Dec 19, 2021 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients
Mercy Inpatient Medical Associates Inc. CurrentSince Dec 30, 2024 Accepting new patients
Prospect Waterbury, Inc. CurrentSince Oct 1, 2016 Accepting new patients
Neurological Specialist, P.C. CurrentSince Mar 1, 2014 Accepting new patients
The Charlotte Hungerford Hospital CurrentSince Jul 6, 2015 Accepting new patients
The Charlotte Hungerford Hospital CurrentSince Jul 6, 2015 Accepting new patients
Bristol Hospital Multi Specialty Group, Inc CurrentSince Oct 22, 2025 Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

455 Lewis Ave
Ste 221
Meriden, CT 06451
Phone (203) 694-7595

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

99 Hawley Ln
Ste 1120
Stratford, CT 06614
Phone (203) 377-4788

540 Litchfield St
Torrington, CT 06790
Phone (860) 496-6361

780 Litchfield St
Torrington, CT 06790
Phone (860) 350-9000

160 Robbins St
Waterbury, CT 06708
Phone (203) 573-7284

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

233 Carew St
#101
Springfield, MA 01104
Phone (413) 748-9212

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

Interoperability endpoints

  • Direct secure messaging: pfattahi2367106@direct.trinity-health.org

Organizations & group practices 11

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 5

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423180800000",
    "number": "1669625174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TPKE",
            "address_2": "SUITE 307 - WATERBURY NEUROLOGY LLC",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-758-2635",
            "fax_number": "203-758-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TPKE",
            "address_2": "SUITE 307 - WATERBURY NEUROLOGY LLC",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-758-2635",
            "fax_number": "203-758-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATTAHI",
        "first_name": "POOIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2015-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CT",
            "license": "50832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, CT

Sources for this page

Verify at the official NPI Registry.