Individual provider Active NPI

Robert J Welsch, MD

  • Internal Medicine Physician
  • East Lyme, CT
National Provider Identifier
1720061906
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
23094 Issued in CT
Practice address
324 Flanders Rd
East Lyme, CT 06333-1735
Phone
(860) 739-6953
Fax
(860) 739-2523
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 023094 CT
Internal Medicine Physician 207R00000X 23094 CT Primary

Addresses

Primary practice location

324 Flanders Rd
East Lyme, CT 06333-1735

Mailing address

324 Flanders Rd
East Lyme, CT 06333-1735
Phone (860) 739-6953

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
I20100923000445 CT Practitioner - Internal MedicinePractitioner - Family Practice 6800912254 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023094CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc Family Medicine CurrentSince Apr 1, 2017 Accepting new patients

Locations

324 Flanders Rd
East Lyme, CT 06333
Phone (860) 739-1864

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1720061906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 FLANDERS RD",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331735",
            "telephone_number": "860-739-6953",
            "fax_number": "860-739-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 FLANDERS RD",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331735",
            "telephone_number": "860-739-6953",
            "fax_number": "860-739-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELSCH",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "023094",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "23094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lyme, CT

Sources for this page

Verify at the official NPI Registry.