Individual provider Active NPI

Peter Porrello, MD

  • Emergency Medicine Physician
  • Waterbury, CT
National Provider Identifier
1710962097
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
038050 Issued in CT
Practice address
64 Robbins St
Waterbury, CT 06708-2613
Phone
(203) 573-6295
Fax
(203) 573-7613
NPI assigned
Dec 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 038050 CT Primary

Addresses

Primary practice location

64 Robbins St
Waterbury, CT 06708-2613

Mailing address

64 Robbins St
Waterbury, CT 06708-2613
Phone (203) 573-6295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100202000350 CT Practitioner - Emergency Medicine 3971646761 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of New York Downstate Medical Center, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Danbury HospitalGroup PAC ID 1557273935, 49 clinicians

Practice addresses (Care Compare)

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
038050CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norwalk Hospital Association CurrentSince Mar 1, 2020 Accepting new patients
Nuvance Health Medical Practice CT, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Emergency Physicians of Connecticut PC Emergency Medicine CurrentSince Jan 3, 2016 Accepting new patients
Danbury Hospital CurrentSince Dec 17, 2013 Accepting new patients
Norwalk Hospital Association CurrentSince Mar 1, 2020 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

20 Germantown Rd
Danbury, CT 06810
Phone (203) 739-4820

21 Elm St
New Milford, CT 06776
Phone (860) 210-5000

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

Interoperability endpoints

  • Direct secure messaging: pporrello@direct.wtbyhosp.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1710962097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 ROBBINS ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082613",
            "telephone_number": "203-573-6295",
            "fax_number": "203-573-7613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 ROBBINS ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082613",
            "telephone_number": "203-573-6295",
            "fax_number": "203-573-7613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORRELLO",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "038050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.