Individual provider Active NPI

Azimuddin Kazi, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Stratford, CT
National Provider Identifier
1750321428
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
041941 Issued in CT
Practice address
2590 Main St
Stratford, CT 06615-5838
Phone
(203) 377-5988
Fax
(203) 380-0531
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 041941 CT Primary

Addresses

Primary practice location

2590 Main St
Stratford, CT 06615-5838

Mailing address

30 Brookfield Rd
Seymour, CT 06483-2378
Phone (203) 888-7846

Other identifiers 1

IdentifierTypeStateIssuer
001419416MedicaidCO

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
I20040621001011 CT Practitioner - Neuropsychiatry 0244215655 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neuropsychiatry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurological Specialist PCGroup PAC ID 3375536469, 5 clinicians

Practice addresses (Care Compare)

99 Hawley LN
Suite 1120
Stratford, CT 06614-1208
Phone 2033775988303

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041941CTMDNeurology with Special Qualifications in Child Neurology Physician

Interoperability endpoints

  • Direct secure messaging: akazi6470@direct.ynhh.org
  • Direct secure messaging: azimuddink.kazi@xdr.hhchealthdirect.org

Organizations & group practices 2

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1750321428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BROOKFIELD RD",
            "city": "SEYMOUR",
            "state": "CT",
            "postal_code": "064832378",
            "telephone_number": "203-888-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2590 MAIN ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066155838",
            "telephone_number": "203-377-5988",
            "fax_number": "203-380-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZI",
        "first_name": "AZIMUDDIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CT",
            "license": "041941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001419416",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, CT

Sources for this page

Verify at the official NPI Registry.