Prism Sports Medicine, LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

PRISM SPORTS MEDICINE, LLC

Practice address

31 Seymour St Ste 204
Hartford, CT 06106-5505

Phone

(860) 421-3233

NPI assigned

Apr 8, 2020

Last updated

Nov 19, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carl Nissen, MDNPI 1982601530

Title

Owner

Phone

(860) 282-4128

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

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.

• Carl W Nissen, MD

  • Orthopaedic Surgery Physician
  • Hartford, CT
  • NPI 1982601530
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1851920029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 PINNACLE RIDGE RD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060323041",
            "telephone_number": "860-421-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 SEYMOUR ST STE 204",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065505",
            "telephone_number": "860-421-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISM SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-08",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A",
        "authorized_official_last_name": "NISSEN",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-282-4128",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000000",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arike Price, M.D.
• Cynthia Laverne Price, M.D.
• Primary Health L.L.C
• Charles Arthur Primiano, M.D.
• Erin Principe, LMSW
• Yelena Pristyazhnyuk
• Pro-Care Health & Allied Services
• Procare Counseling CT, LLC
• Proficient Nurse Practitioners PNP
• Project Thrive CT

• Orthopaedic Surgery Physician in Hartford, CT
• Providers in Hartford, CT by specialty
• Orthopaedic Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.