NPIMap

Individual provider Active NPI

Mark Kasabuski

  • Pharmacist
  • Lisbon, CT
National Provider Identifier
1669847323
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT0010798 Issued in CT
Practice address
195 River Rd
Lisbon, CT 06351-3253
Phone
(860) 823-2961
NPI assigned
Dec 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT0010798 CT Primary

Addresses

Primary practice location

195 River Rd
Lisbon, CT 06351-3253

Mailing address

49 Juniper Drive Ext
Ashaway, RI 02804-1905
Phone (401) 447-9019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PCT0010798CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Leafwell Providers NJ, P.C. Current Accepting new patients
Gavin Moreland MD, P.C. Current Accepting new patients
Leafwell Providers, P.a. Current Accepting new patients

Organizations & group practices 3

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": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1669847323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 JUNIPER DRIVE EXT",
            "city": "ASHAWAY",
            "state": "RI",
            "postal_code": "028041905",
            "telephone_number": "401-447-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 RIVER RD",
            "city": "LISBON",
            "state": "CT",
            "postal_code": "063513253",
            "telephone_number": "860-823-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASABUSKI",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-07",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT0010798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisbon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; 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.