NPIMap

Organization Active NPI

Chestnut Knoll Physicians Group PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Shelton, CT
National Provider Identifier
1780477729
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
CHESTNUT KNOLL PHYSICIANS GROUP PC
Practice address
5 Research Dr
Shelton, CT 06484-6232
Phone
(203) 901-2493
NPI assigned
May 23, 2025
Last updated
May 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Authorized official

Name
Manoj Wadhwani
Title
Owner
Phone
(203) 901-2493

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X Primary

Addresses

Primary practice location

5 Research Dr
Shelton, CT 06484-6232

Mailing address

5 Research Dr
Shelton, CT 06484-6232
Phone (203) 901-2493

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250821003036 CT Part B Supplier - Clinic/Group Practice 3476053760 Receives reassigned benefits from 1 practitioner
Practice locations: Shelton, CT
O20260526002447 NC Part B Supplier - Clinic/Group Practice 3476053760 Receives reassigned benefits from 29 practitioners
Practice locations: Mooresville, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1780477729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 RESEARCH DR",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846232",
            "telephone_number": "203-901-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 RESEARCH DR",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846232",
            "telephone_number": "203-901-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTNUT KNOLL PHYSICIANS GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "WADHWANI",
        "authorized_official_first_name": "MANOJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-901-2493"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.