NPIMap

Organization Active NPI

Value Based Long Term Care K PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Shelton, CT
National Provider Identifier
1831921378
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
VALUE BASED LONG TERM CARE K PC
Practice address
5 Research Dr
Shelton, CT 06484-6232
Phone
(203) 901-2493
Fax
(866) 497-2991
NPI assigned
Aug 14, 2024
Last updated
Aug 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240904003650 CT Part B Supplier - Clinic/Group Practice 1355881418 Receives reassigned benefits from 68 practitioners
Practice locations: Farmington, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 70

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 70

NPI Registry JSON

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1831921378",
    "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",
            "fax_number": "866-497-2991"
        },
        {
            "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",
            "fax_number": "866-497-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALUE BASED LONG TERM CARE K PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "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": "193200000X MULTI-SPECIALTY 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 Aug 16, 2024; 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.