Black Rock Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

037492 Issued in CT

Legal business name

BLACK ROCK PEDIATRICS

Practice address

1817 Black Rock Tpke
Suite 206
Fairfield, CT 06825-3546

Phone

(203) 337-5333

NPI assigned

Jan 20, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Elin R Cohen, M.D.

Title

President

Phone

(203) 650-6030

Specialties & licenses 1

Addresses

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 4

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

• Ruchi Kapoor, PA

  • Medical Physician Assistant
  • Fairfield, CT
  • NPI 1780617928
  NPD (past)
• Stephanie Alysse Mason

  • Pediatrics Physician
  • Fairfield, CT
  • NPI 1700240306
  NPD (past)
• Mark H Vincent, MD

  • Pediatrics Physician
  • Norwalk, CT
  • NPI 1962417279
  NPD (past)
• Nicole Ann Woering, NP-C

  • Family Nurse Practitioner
  • Danbury, CT
  • NPI 1265769467
  NPD (past)

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325721600000",
    "number": "1760629232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 BLACK ROCK TPKE",
            "address_2": "SUITE 206",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253546",
            "telephone_number": "203-337-5333",
            "fax_number": "203-337-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 BLACK ROCK TPKE",
            "address_2": "SUITE 206",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253546",
            "telephone_number": "203-337-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK ROCK PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-20",
        "last_updated": "2012-01-05",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "ELIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-650-6030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "037492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David F Bindelglass, MD
• Taylor Bird, MS CCC-SLP
• Lacy C Birdseye, APRN
• BJ'S Wholesale Club Inc.
• Black Rock Counseling LLC
• Black Rock Pharmacy LLC
• Janette A. Black, D.D.S.
• Rachel Black
• Emily Blair, M.D., D.O.
• Heather Blair, SLP

• Pediatrics Physician in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Pediatrics Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.