Individual provider Active NPI

Nirmala Panwar, M.D.

  • General Practice Physician
  • Southington, CT
National Provider Identifier
1720215817
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
052442 Issued in CT
Practice address
1783 Meriden Waterbury Tpke #13
Southington, CT 06489-0648
Phone
(203) 404-1010
Fax
(860) 426-2898
NPI assigned
Jun 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 052442 CT Primary

Addresses

Primary practice location

1783 Meriden Waterbury Tpke #13
Southington, CT 06489-0648

Mailing address

102 Pembroke Rd
Hamden, CT 06514-2626
Phone (203) 393-5280

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
I20150831001181 CT Practitioner - General PracticePractitioner - Other (Physician) 0547576241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1783 Meriden Waterbury Tpke
M13
Southington, CT 06489
Phone (203) 404-1010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
052442CTMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale Home Care Physicians Inc General Practice CurrentSince Jun 3, 2015 Accepting new patients

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": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1720215817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PEMBROKE RD",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065142626",
            "telephone_number": "203-393-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1783 MERIDEN WATERBURY TPKE #13",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064890648",
            "telephone_number": "203-404-1010",
            "fax_number": "860-426-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANWAR",
        "first_name": "NIRMALA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CT",
            "license": "052442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

Verify at the official NPI Registry.