NPIMap

Organization Active NPI

Northeastern Pulmonary Associates LLC

  • Pulmonary Disease Physician
  • Vernon, CT
National Provider Identifier
1730134305
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
NORTHEASTERN PULMONARY ASSOCIATES LLC
Practice address
27 Naek Road
Suite 2
Vernon, CT 06066
Phone
(860) 875-2444
Fax
(860) 872-2936
NPI assigned
May 23, 2006
Last updated
Feb 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Authorized official

Name
Mohammad Saud Anwar, MD
Title
Managing Partner
Phone
(860) 875-2444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X Primary

Addresses

Primary practice location

27 Naek Road
Suite 2
Vernon, CT 06066

Mailing address

27 Naek Rd
Suite 2
Vernon, CT 06066-3942
Phone (860) 875-2444

Other identifiers 1

IdentifierTypeStateIssuer
004395275OtherCTSTATE WELFARE, EDS PROGRA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040518000125 CT Part B Supplier - Clinic/Group Practice 6608866983 Receives reassigned benefits from 12 practitioners
Practice locations: Vernon, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1730134305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 NAEK RD",
            "address_2": "SUITE 2",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060663942",
            "telephone_number": "860-875-2444",
            "fax_number": "860-872-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 NAEK ROAD",
            "address_2": "SUITE 2",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "06066",
            "telephone_number": "860-875-2444",
            "fax_number": "860-872-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN PULMONARY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A",
        "authorized_official_last_name": "ANWAR",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "SAUD",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "860-875-2444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE WELFARE, EDS PROGRA",
            "identifier": "004395275",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.