NPIMap

Organization Active NPI

Connecticut Gastroenterology Assoc PC

  • Gastroenterology Physician
  • Hartford, CT
National Provider Identifier
1700917523
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CONNECTICUT GASTROENTEROLOGY ASSOC PC
Practice address
1000 Asylum Ave
Suite 3212
Hartford, CT 06105
Phone
(860) 522-1171
Fax
(860) 493-6524
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Authorized official

Name
Dr. Michael Butensky, M.D.NPI 1487681136
Title
President
Phone
(860) 522-1171

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

1000 Asylum Ave
Suite 3212
Hartford, CT 06105

Mailing address

1000 Asylum Ave
Suite 3212
Hartford, CT 06105-1770
Phone (860) 522-1171

Other identifiers 2

IdentifierTypeStateIssuer
C00203OtherCTMEDICARE GROUP NUMBER
004065934MedicaidCT

Other names 1

  • Connecticut Gastroenterology Associates PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041201000669 CT Part B Supplier - Clinic/Group Practice 8123083193 Receives reassigned benefits from 12 practitioners
Practice locations: Hartford, CT

National Provider Directory

National Provider Directory

Locations

35 Nod Rd
Ste 104
Avon, CT 06001
Phone (860) 242-3000

701 Cottage Grove Rd
Ste 110
Bloomfield, CT 06002
Phone (860) 318-5682

701 Cottage Grove Rd
Ste A2110
Bloomfield, CT 06002

150 Hazard Ave
Bldg C
Enfield, CT 06082
Phone (860) 830-2350

18 Haynes St
Ste A
Manchester, CT 06040
Phone (860) 522-1171

515 Middle Tpke W
Ste 120
Manchester, CT 06040
Phone (860) 533-0008

506 Cromwell Ave
Rocky Hill, CT 06067
Phone (860) 529-1287

132 Mansfield Ave
Ste 112
Willimantic, CT 06226

2 Concorde Way
Bldg 2
Windsor Locks, CT 06096
Phone (860) 242-8756

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529280000000",
    "number": "1700917523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE",
            "address_2": "SUITE 3212",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051770",
            "telephone_number": "860-522-1171",
            "fax_number": "860-493-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE",
            "address_2": "SUITE 3212",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06105",
            "telephone_number": "860-522-1171",
            "fax_number": "860-493-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT GASTROENTEROLOGY ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2018-06-18",
        "status": "A",
        "authorized_official_last_name": "BUTENSKY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-522-1171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C00203",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004065934",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connecticut Gastroenterology Associates PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.