Individual provider Active NPI

John Santilli, M.D.

  • Specialist
  • Shelton, CT
National Provider Identifier
1811961469
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
017262 Issued in CT
Practice address
4 Corporate Dr
Ste 295
Shelton, CT 06484-6240
Phone
(203) 374-6103
Fax
(203) 374-1663
NPI assigned
Feb 13, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 017262 CT Primary

Addresses

Primary practice location

4 Corporate Dr
Ste 295
Shelton, CT 06484-6240

Mailing address

130 Primrose LN
Fairfield, CT 06825-2307
Phone (203) 259-1055

Other identifiers 1

IdentifierTypeStateIssuer
001172626MedicaidCT

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
I20040726001224 CT Practitioner - Allergy/Immunology 1850361163 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Center of Connecticut, PC CurrentSince Jan 1, 2012 Accepting new patients
The Connecticut Dermatology Group PLLC PastSince Feb 1, 2026 Accepting new patients

Locations

4675 Main St
Bridgeport, CT 06606
Phone (203) 374-6103

761 Main Ave
Ste 105
Norwalk, CT 06851
Phone (203) 374-6103

4 Corporate Dr
Ste 295
Shelton, CT 06484
Phone (203) 374-6103

Organizations & group practices 2

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1811961469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 PRIMROSE LN",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068252307",
            "telephone_number": "203-259-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CORPORATE DR",
            "address_2": "STE 295",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846240",
            "telephone_number": "203-374-6103",
            "fax_number": "203-374-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTILLI",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "017262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001172626",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

Verify at the official NPI Registry.