Organization Active NPI

Progressive Care Medical Group of CT, PLLC

  • Nurse Practitioner
  • Southport, CT
National Provider Identifier
1679107940
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
PROGRESSIVE CARE MEDICAL GROUP OF CT, PLLC
Practice address
917 Mill Hill Ter
Southport, CT 06890-3200
Phone
(800) 860-3274
Fax
(888) 910-1059
NPI assigned
Feb 26, 2020
Last updated
Sep 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Authorized official

Name
Dr. Deepak Patel, MD
Title
Authorized Official
Phone
(516) 855-5255

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU
Nurse Practitioner 363L00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

917 Mill Hill Ter
Southport, CT 06890-3200

Mailing address

PO Box 1040
Syosset, NY 11791-0010
Phone (800) 860-3274

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211026001909 CT Part B Supplier - Clinic/Group Practice 5193113082 Receives reassigned benefits from 3 practitioners
Practice locations: Waterford, CT; Wilton, CT; Westport, CT; Stamford, CT; Norwich, CT; Southport, CT; Greenwich, CT; New Haven, CT…

National Provider Directory

National Provider Directory

Locations

162 New Canaan Ave
Norwalk, CT 06850
Phone (203) 857-1836

930 Mill Hill Ter
Southport, CT 06890
Phone (203) 259-7894

211 Danbury Rd
Wilton, CT 06897
Phone (203) 423-7500

Practitioners & affiliated clinicians

Practitioners 4

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": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790294400000",
    "number": "1679107940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1040",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117910010",
            "telephone_number": "800-860-3274",
            "fax_number": "888-910-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 MILL HILL TER",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068903200",
            "telephone_number": "800-860-3274",
            "fax_number": "888-910-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE CARE MEDICAL GROUP OF CT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "516-855-5255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; 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.