James T Belisle, MD

Individual provider Active NPI Neonatal-Perinatal Medicine Physician · Norwalk, CT

NPI 1679543136 · NPPES record last updated Apr 25, 2022

Key facts

NPI
1679543136
Entity type
Individual (NPI type 1)
Primary specialty
Neonatal-Perinatal Medicine Physician 2080N0001X
License
029963 (CT)
Practice address
24 Stevens St
Norwalk, CT 06850-3852
Phone
(203) 855-3683
Fax
(203) 952-3413
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20081013000136 CT Practitioner - Pediatric Medicine
Practitioner - Obstetrics/Gynecology
6204904667

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
029963CTMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Specialists of Southeastern Connecticut, Inc. Neonatal-Perinatal Medicine Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 029963 CT Yes

Addresses

Primary practice location

24 Stevens St
Norwalk, CT 06850-3852

Mailing address

24 Stevens St
Norwalk, CT 06850-3852
Phone (203) 855-3683

Other identifiers

IdentifierTypeStateIssuer
010029963CT02OtherCTANTHEM B/C
OV8255OtherCTHEALTHNET
001299636MedicaidCT
722078OtherCTCONNECTICARE
7142170OtherCTAETNA

Other providers in Norwalk, CT

All providers in Norwalk, CT · Neonatal-Perinatal Medicine Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.