Park Avenue Medical

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

044791 Issued in CT

Legal business name

PARK AVENUE MEDICAL

Practice address

85 Barnes Rd Ste 202
Wallingford, CT 06492

Phone

(203) 309-0070

Fax

(203) 309-0071

NPI assigned

Apr 9, 2012

Organization subpart

No

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

Authorized official

Name

Anace Said, MDNPI 1487696910

Title

Business Owner

Phone

(203) 309-0070

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Park Avenue Medical LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anace H Said, M.D.

  • Internal Medicine Physician
  • Wallingford, CT
  • NPI 1487696910
  Medicare reassignment Care Compare group NPD Authorized official
• Lauren Mary Dempsey, APRN

  • Family Nurse Practitioner
  • Wallingford, CT
  • NPI 1316602360
  Medicare reassignment Care Compare group NPD
• Hilary Sullivan, APRN

  • Family Nurse Practitioner
  • Wallingford, CT
  • NPI 1528692480
  Medicare reassignment Care Compare group NPD
• Alexandria Rose Viscosi, APRN

  • Family Nurse Practitioner
  • Wallingford, CT
  • NPI 1881338275
  Medicare reassignment Care Compare group NPD
• Chelsea Ann Gardner, FNP

  • Family Medicine Physician
  • Wallingford, CT
  • NPI 1265003826
  Medicare reassignment NPD
• Ursula L Hoxie, APRN

  • Family Nurse Practitioner
  • Wallingford, CT
  • NPI 1477929420
  Medicare reassignment NPD
• Susan Mary Paxton

  • Adult Health Nurse Practitioner
  • Bridgeport, CT
  • NPI 1710455316
  Medicare reassignment NPD

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655683200000",
    "number": "1740546399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 BARNES RD STE 202",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-309-0070",
            "fax_number": "203-309-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 BARNES RD STE 202",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-309-0070",
            "fax_number": "203-309-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-09",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A",
        "authorized_official_last_name": "SAID",
        "authorized_official_first_name": "ANACE",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "203-309-0070",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "044791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008002162",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Avenue Medical LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Liza Alexis Paolini, APRN
• Amanda Papa, LCSW
• Kathryn M Papadikis, M.D.
• Paul Vincent Parente, LCSW
• Ronald S Paret, M.D.
• Sylvia K Parker, GNP-BC
• Alicia Marie Pascale, DPT
• Michael Pasinski, LCSW
• Terri Passante
• Rachel W Pata, D.P.T

• Internal Medicine Physician in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.