NPIMap

Organization Active NPI

Connecticut Gastroenterology Consultants, P.C.

  • Gastroenterology Physician
  • New Haven, CT
National Provider Identifier
1669674743
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CONNECTICUT GASTROENTEROLOGY CONSULTANTS, P.C.
Practice address
40 Temple St
Suite 4a
New Haven, CT 06510-2715
Phone
(203) 777-0304
Fax
(203) 401-4687
NPI assigned
Jun 1, 2007
Last updated
Feb 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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

Authorized official

Name
Michael C Bennick, M.D.NPI 1720129034
Title
President
Phone
(203) 777-0304

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X Primary

Addresses

Primary practice location

40 Temple St
Suite 4a
New Haven, CT 06510-2715

Mailing address

40 Temple St
Suite 4a
New Haven, CT 06510-2715
Phone (203) 777-0304

Other identifiers 1

IdentifierTypeStateIssuer
004001541MedicaidCT

National Provider Directory

National Provider Directory

Locations

88 Noble Ave
Milford, CT 06460
Phone (203) 877-0566

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1669674743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 TEMPLE ST",
            "address_2": "SUITE 4A",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102715",
            "telephone_number": "203-777-0304",
            "fax_number": "203-401-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 TEMPLE ST",
            "address_2": "SUITE 4A",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102715",
            "telephone_number": "203-777-0304",
            "fax_number": "203-401-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT GASTROENTEROLOGY CONSULTANTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "BENNICK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-777-0304",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004001541",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.