NPIMap

Individual provider Active NPI

Gregory L Shangold, MD

  • Emergency Medicine Physician
  • Willimantic, CT
National Provider Identifier
1770540262
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
040248 Issued in CT
Practice address
112 Mansfield Ave
Windham Hospital
Willimantic, CT 06226-2041
Phone
(860) 456-6078
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 040248 CT Primary

Addresses

Primary practice location

112 Mansfield Ave
Windham Hospital
Willimantic, CT 06226-2041

Mailing address

112 Mansfield Ave
Windham Hospital
Willimantic, CT 06226-2041
Phone (860) 456-6078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041130000948 CT Practitioner - Emergency Medicine 0648235705 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nems PLLCGroup PAC ID 2466792833, 37 clinicians

Practice addresses (Care Compare)

435 Lewis Ave
Meriden, CT 06451-2101
Phone (203) 694-8200

Hospital & facility affiliations

  • Windham Community Memorial Hospital Hospital, Willimantic, CT, CCN 070021
  • Day Kimball Hospital Hospital, Putnam, CT, CCN 070003

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

Merit-based Incentive Payment System (MIPS)

Final score
84.01 of 100Reported as group
Quality
71.79
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040248CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Pathology Associates, P.C. Current Accepting new patients
Nems PLLC Emergency Medicine CurrentSince Mar 14, 2019 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Jan 26, 2021 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Jan 26, 2021 Accepting new patients
Hartford Hospital Emergency Medicine CurrentSince Oct 1, 2013 Accepting new patients
Hartford Hospital CurrentSince Oct 1, 2013 Accepting new patients
Northeast Emergency Medicine Specialists, LLC Emergency Medicine CurrentSince Apr 16, 2008 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Past Accepting new patients

Locations

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

81 Meriden Ave
Southington, CT 06489
Phone (860) 224-5540

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

Interoperability endpoints

  • Direct secure messaging: gregory.shangold@xdr.hhchealthdirect.org

Organizations & group practices 8

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.

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1770540262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MANSFIELD AVE",
            "address_2": "WINDHAM HOSPITAL",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262041",
            "telephone_number": "860-456-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MANSFIELD AVE",
            "address_2": "WINDHAM HOSPITAL",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262041",
            "telephone_number": "860-456-6078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANGOLD",
        "first_name": "GREGORY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "040248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.