Individual provider Active NPI

David Bruce Walshin, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Stamford, CT
National Provider Identifier
1679566384
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
034578 Issued in CT
Practice address
1425 Bedford St Apt 4H
Stamford, CT 06905-5216
Phone
(203) 352-1217
Fax
(203) 902-0152
NPI assigned
Aug 26, 2005
Reactivated
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 034578 CT Primary

Addresses

Primary practice location

1425 Bedford St Apt 4H
Stamford, CT 06905-5216

Mailing address

1425 Bedford St Apt 4H
Stamford, CT 06905-5216
Phone (203) 352-1217

Other identifiers 1

IdentifierTypeStateIssuer
001345786MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081111000677 CT Practitioner - Physical Medicine and Rehabilitation 8820157480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
State University of New York Downstate Medical Center, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1425 Bedford St
Apt 4H
Stamford, CT 06905-5216
Phone (203) 352-1217

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
034578CTMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David B. Walshin, M.D., P.C. Physical Medicine & Rehabilitation CurrentSince Jan 1, 2007 Accepting new patients

Locations

78 Harvard Ave
Ste 310
Stamford, CT 06902
Phone (203) 352-1217

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.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1679566384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 BEDFORD ST APT 4H",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055216",
            "telephone_number": "203-352-1217",
            "fax_number": "203-902-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 BEDFORD ST APT 4H",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055216",
            "telephone_number": "203-352-1217",
            "fax_number": "203-902-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSHIN",
        "first_name": "DAVID",
        "middle_name": "BRUCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "deactivation_date": "2006-03-27",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CT",
            "license": "034578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001345786",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.