Andrew David Shiller, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

151898 Issued in MA

Practice address

103 Holmes Rd
Ridgefield, CT 06877-4304

Phone

(203) 290-1368

Fax

(888) 972-1204

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2022 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Gaylord Hospital, Inc.

  • Long Term Care Hospital
  • Wallingford, CT
  • NPI 1730137753
  NPD (past)
• Ics Medical, P.C.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Monsey, NY
  • NPI 1841515723
  NPD (past)
• Integrative Medical Care PC

  • Specialist
  • Castleton, NY
  • NPI 1275533895
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1689680282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 HOLMES RD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774304",
            "telephone_number": "203-290-1368",
            "fax_number": "888-972-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 HOLMES RD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774304",
            "telephone_number": "203-290-1368",
            "fax_number": "888-972-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILLER",
        "first_name": "ANDREW",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "151898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serafima M. Glouzgal
• Serene Mind Psychiatry LLC
• Seven Twelve Wellness LLC
• Krisha Jayesh Shah
• Judith Arlene Shapiro, M.A., LMFT
• Ruthann Navarro Short, MSW
• Shteg.Ai
• Danielle Marciano Sileo, LMFT
• Kristin Simoncelli, O.D.
• Christopher Skennion, LPCA

• Physical Medicine & Rehabilitation Physician in Ridgefield, CT
• Providers in Ridgefield, CT by specialty
• Physical Medicine & Rehabilitation Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.