Organization Active NPI

Healthy Children Pediatrics, LLC

  • Pediatrics Physician
  • Middlebury, CT
National Provider Identifier
1710639455
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
HEALTHY CHILDREN PEDIATRICS, LLC
Practice address
1655 Straits Tpke
Middlebury, CT 06762-1839
Phone
(475) 444-2346
NPI assigned
Jan 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Authorized official

Name
Ezzat Hafez, MDNPI 1548270614
Title
Managing Member
Phone
(475) 444-2346

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1655 Straits Tpke
Middlebury, CT 06762-1839

Mailing address

1655 Straits Tpke
Middlebury, CT 06762-1839

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D2253455Healthy Children Pediatrics, LLC1655 Straits Tpke, Middlebury, CT 06762Certificate of waiverFeb 21, 2028

National Provider Directory

National Provider Directory

Locations

1655 Straits Tpke
Middlebury, CT 06762
Phone (475) 444-2346

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1710639455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 STRAITS TPKE",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 STRAITS TPKE",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621839",
            "telephone_number": "475-444-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY CHILDREN PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "HAFEZ",
        "authorized_official_first_name": "EZZAT",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "475-444-2346",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.