Ahmad Fotovat, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

022045 Issued in CT

Practice address

115 Technology Dr
C-100
Trumbull, CT 06611-1395

Phone

(203) 268-5212

Fax

(203) 268-6779

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 9

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ahmad.fotovat@xdr.hhchealthdirect.org

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.

• Neighborhood Health, Inc.

  • General Practice Physician
  • Torrington, CT
  • NPI 1043544489

  Surgery

  Medicare reassignment NPD

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1740234178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 TECHNOLOGY DR",
            "address_2": "C-100",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066116337",
            "telephone_number": "203-268-5212",
            "fax_number": "203-268-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 TECHNOLOGY DR",
            "address_2": "C-100",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066111395",
            "telephone_number": "203-268-5212",
            "fax_number": "203-268-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOTOVAT",
        "first_name": "AHMAD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "022045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4395958",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS",
            "identifier": "512H41",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - HMO",
            "identifier": "1176502",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2V5317",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "796029",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - PPO",
            "identifier": "4662047",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "010022045CT04",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BETTER HEALTH ADVANTAGE",
            "identifier": "103685",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "ZS080",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Forbes
• Danielle Ford, BCBA, LBA
• Danielle Lauren Forma
• Jennifer Ayers Formoso, LCSW
• Crista Forstrom
• Mary C Fraga, M.D.
• Richard Gregory Free, MD
• William Lawrence Freed, D.C.
• Lauren Marie Freer
• Marnie B. Frey, APRN

• Surgery Physician in Trumbull, CT
• Providers in Trumbull, CT by specialty
• Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.