NPIMap

Organization Active NPI

Norwich Infectious Disease Associates LLC

  • Specialist
  • Norwich, CT
National Provider Identifier
1730332313
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
I17254 Issued in CT
Legal business name
NORWICH INFECTIOUS DISEASE ASSOCIATES LLC
Practice address
112 Lafayette St
Norwich, CT 06360-2737
Phone
(860) 886-8545
Fax
(855) 629-7856
NPI assigned
Oct 28, 2008
Last updated
Oct 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Authorized official

Name
Michael J Rajkumar, MDNPI 1689651143
Title
President
Phone
(860) 886-8545

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X I17254 CT Primary

Addresses

Primary practice location

112 Lafayette St
Norwich, CT 06360-2737

Mailing address

112 Lafayette St
Norwich, CT 06360-2737
Phone (860) 886-8545

Other identifiers 4

IdentifierTypeStateIssuer
1730332313OtherCTAETNA
001386607MedicaidCT
010038660CT02OtherCTANTHEM
9621008OtherCTCIGNA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412294400000",
    "number": "1730332313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 LAFAYETTE ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602737",
            "telephone_number": "860-886-8545",
            "fax_number": "855-629-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LAFAYETTE ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602737",
            "telephone_number": "860-886-8545",
            "fax_number": "855-629-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORWICH INFECTIOUS DISEASE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2014-10-03",
        "status": "A",
        "authorized_official_last_name": "RAJKUMAR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-886-8545",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "I17254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1730332313",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001386607",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "010038660CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9621008",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.