Individual provider Active NPI

Ross L Winakor, MD

  • Family Medicine Physician
  • Storrs, CT
National Provider Identifier
1720071681
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
041425 Issued in CT
Practice address
34 Professional Park Rd.
Storrs, CT 06268
Phone
(860) 487-0002
Fax
(860) 429-1663
NPI assigned
Aug 25, 2005
Last updated
Apr 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 041425 CT Primary

Addresses

Primary practice location

34 Professional Park Rd.
Storrs, CT 06268

Mailing address

34 Professional Park Rd.
Storrs, CT 06268
Phone (860) 487-0002

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
I20041102000195 CT Practitioner - Family Practice 9032171004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mansfield Family Practice LLCGroup PAC ID 2961433594, 4 clinicians

Practice addresses (Care Compare)

34 Proffessional Park Rd
Storrs Mansfield, CT 06268-1659
Phone 8604870002109

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041425CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mansfield Family Practice LLC Family Medicine CurrentSince Aug 1, 2003 Accepting new patients
Physician Management Services of Connecticut, LLC Family Medicine Past Accepting new patients

Locations

34 Professional Park Rd
Storrs Mansfield, CT 06268
Phone (860) 429-2803

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71598
  • Direct secure messaging: ross.winakor@mfp.directbygreenway.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1720071681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 PROFESSIONAL PARK RD.",
            "city": "STORRS",
            "state": "CT",
            "postal_code": "06268",
            "telephone_number": "860-487-0002",
            "fax_number": "860-429-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PROFESSIONAL PARK RD.",
            "city": "STORRS",
            "state": "CT",
            "postal_code": "06268",
            "telephone_number": "860-487-0002",
            "fax_number": "860-429-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINAKOR",
        "first_name": "ROSS",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "041425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Storrs, CT

Sources for this page

Verify at the official NPI Registry.