NPIMap

Organization Active NPI

Civic Farmington, PLLC

  • Infusion Therapy Clinic/Center
  • Farmington, CT
National Provider Identifier
1760138366
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
CIVIC FARMINGTON, PLLC
Practice address
220 Farmington Ave
Farmington, CT 06032-1949
Phone
(203) 883-0038
Fax
(203) 724-4838
NPI assigned
Feb 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Authorized official

Name
Barry D Stein, MDNPI 1952318487
Title
Partner
Phone
(203) 883-0038

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X Primary

Addresses

Primary practice location

220 Farmington Ave
Farmington, CT 06032-1949

Mailing address

249 Danbury Rd
Wilton, CT 06897-4010
Phone (203) 883-0038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220426000149 CT Part B Supplier - Clinic/Group Practice 6608263470 Receives reassigned benefits from 10 practitioners
Practice locations: Farmington, CT

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D2276949Civic Farmington220 Farmington Ave, Ste 2, Farmington, CT 06032Certificate of waiverFeb 16, 2027

National Provider Directory

National Provider Directory

Locations

220 Farmington Ave
Ste 2
Farmington, CT 06032

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1760138366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 DANBURY RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068974010",
            "telephone_number": "203-883-0038",
            "fax_number": "203-724-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321949",
            "telephone_number": "203-883-0038",
            "fax_number": "203-724-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIVIC FARMINGTON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "203-883-0038",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.