Primary Care of Shelton LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

038488 Issued in CT

Legal business name

PRIMARY CARE OF SHELTON LLC

Practice address

555 Bridgeport Ave
Shelton, CT 06484-4749

Phone

(203) 225-0506

NPI assigned

Feb 11, 2007

Last updated

Sep 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bardia Asgari, MDNPI 1811938533

Title

Ceo

Phone

(203) 225-0506

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17254/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bardia Asgari, MD

  • Internal Medicine Physician
  • Shelton, CT
  • NPI 1811938533
  Medicare reassignment Care Compare group NPD Authorized official
• Rianne Boothe, NP

  • Adult Health Nurse Practitioner
  • Shelton, CT
  • NPI 1588437917
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1700927720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BRIDGEPORT AVE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844749",
            "telephone_number": "203-225-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 BRIDGEPORT AVE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844749",
            "telephone_number": "203-225-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE OF SHELTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-11",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "ASGARI",
        "authorized_official_first_name": "BARDIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "203-225-0506",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "038488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Shelton, CT
• Providers in Shelton, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.