Individual provider Active NPI

Michael Steven Kessler

  • Internal Medicine Physician
  • Derby, CT
National Provider Identifier
1770672180
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
56746 Issued in CT
Practice address
300 Seymour Ave Ste 102
Derby, CT 06418-1343
Phone
(203) 516-5303
Fax
(203) 732-8136
NPI assigned
Oct 12, 2006
Last updated
Jan 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 219965 NY
Obstetrics & Gynecology Physician 207V00000X 56746 CT
Internal Medicine Physician 207R00000X 56746 CT Primary

Addresses

Primary practice location

300 Seymour Ave Ste 102
Derby, CT 06418-1343

Mailing address

67 Maple Ave
Derby, CT 06418-1328
Phone (203) 732-1256

Other identifiers 1

IdentifierTypeStateIssuer
02184485MedicaidNY

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
I20171017000429 CT Practitioner - Obstetrics/GynecologyPractitioner - Family Practice 9537235999 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Family Practice
Education
Albert Einstein College of Medicine of Yeshiva University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Docs Medical IncGroup PAC ID 3173895000, 30 clinicians
CT Medical Group Inc.Group PAC ID 9739663105, 35 clinicians

Practice addresses (Care Compare)

317 Foxon Rd
East Haven, CT 06513-2038
Phone (203) 529-3271

521 Boston Post Rd
Orange, CT 06477-3506
Phone (203) 529-3271

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56746CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Docs Medical Inc Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients
Westchester County Health Care Corporation Past Accepting new patients

Locations

317 Foxon Rd
East Haven, CT 06513
Phone (203) 484-9333

521 Boston Post Rd
Orange, CT 06477
Phone (203) 529-3271

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1770672180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MAPLE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181328",
            "telephone_number": "203-732-1256",
            "fax_number": "203-732-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SEYMOUR AVE STE 102",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181343",
            "telephone_number": "203-516-5303",
            "fax_number": "203-732-8136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSLER",
        "first_name": "MICHAEL",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "219965",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "56746",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "56746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02184485",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, CT

Sources for this page

Verify at the official NPI Registry.