Individual provider Active NPI

Stanislaw Piotr Chorzepa, DO

  • Internal Medicine Physician
  • Kensington, CT
National Provider Identifier
1750375127
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
040472 Issued in CT
Practice address
211 New Britain Rd
Suite 103
Kensington, CT 06037-1360
Phone
(860) 893-0300
Fax
(860) 893-0301
NPI assigned
Aug 31, 2005
Last updated
Jun 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 040472 CT Primary

Addresses

Primary practice location

211 New Britain Rd
Suite 103
Kensington, CT 06037-1360

Mailing address

211 New Britain Rd
Suite 103
Berlin, CT 06037-1360
Phone (860) 893-0300

Other identifiers 2

IdentifierTypeStateIssuer
001404722MedicaidCT
1750375127OtherCTNPI INDIVIDUAL

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
I20040223000187 CT Practitioner - Osteopathic Manipulative MedicinePractitioner - Internal Medicine 3375439979 Practice locations: Kensington, CT

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative MedicineAlso: Internal Medicine
Education
University of New England, College of Osteo Medicine, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

211 New Britain Rd
Suite 103
Kensington, CT 06037-3167
Phone (860) 893-0300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040472CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanislaw P. Chorzepa, D.O., LLC Internal Medicine PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1750375127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 NEW BRITAIN RD",
            "address_2": "SUITE 103",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060371360",
            "telephone_number": "860-893-0300",
            "fax_number": "860-893-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 NEW BRITAIN RD",
            "address_2": "SUITE 103",
            "city": "KENSINGTON",
            "state": "CT",
            "postal_code": "060371360",
            "telephone_number": "860-893-0300",
            "fax_number": "860-893-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHORZEPA",
        "first_name": "STANISLAW",
        "middle_name": "PIOTR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "040472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001404722",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1750375127",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kensington, CT

Sources for this page

Verify at the official NPI Registry.