Advanced Colon Care Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ADVANCED COLON CARE INC

Practice address

929 Boston Post Rd
Suite 1
Old Saybrook, CT 06475-2143

Phone

(860) 395-0554

Fax

(860) 395-0448

NPI assigned

Jul 10, 2006

Organization subpart

No

Name

Dr. Maurizio Domenico NicheleNPI 1245264258

Title

President

Phone

(860) 395-0554

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maurizio Domenico Nichele

  • Colon & Rectal Surgery Physician
  • Old Saybrook, CT
  • NPI 1245264258
  NPD (past) Authorized official
• Armen G Ketchedjian, MD

  • Anesthesiology Physician
  • Old Saybrook, CT
  • NPI 1699893099
  NPD (past)

Listed as

Advanced Colon Care IncCCN 07C0001036

Medicare certification status

Terminated Voluntary: merger or closure, Mar 31, 2025From the Provider of Services file

• SHORELINE COLONOSCOPY SUITES Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 28, 2013.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372377600000",
    "number": "1689608697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 BOSTON POST RD",
            "address_2": "SUITE 1",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752143",
            "telephone_number": "860-395-0554",
            "fax_number": "860-395-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 BOSTON POST RD",
            "address_2": "SUITE 1",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752143",
            "telephone_number": "860-395-0554",
            "fax_number": "860-395-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED COLON CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2013-06-28",
        "status": "A",
        "authorized_official_last_name": "NICHELE",
        "authorized_official_first_name": "MAURIZIO",
        "authorized_official_middle_name": "DOMENICO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-395-0554",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHORELINE COLONOSCOPY SUITES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Old Saybrook, CT
• Ambulatory Surgical Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.