Silver Birch MD LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SILVER BIRCH MD LLC

Practice address

15 Palomba Dr
Enfield, CT 06082-3888

Phone

(860) 951-2198

NPI assigned

Dec 9, 2024

Organization subpart

No

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

Authorized official

Name

Ian Sterling Tucker, MDNPI 1538130836

Title

Owner/Physician Owner

Phone

(860) 951-2198

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ian Sterling Tucker, MD

  • Family Medicine Physician
  • Enfield, CT
  • NPI 1538130836
  Medicare reassignment NPD Authorized official
• Timothy Alan Fignar, MD

  • Family Medicine Physician
  • Enfield, CT
  • NPI 1396766440
  NPD (past)
• Nicole Johnston Misiaszek, P.A.

  • Medical Physician Assistant
  • Enfield, CT
  • NPI 1770772063
  NPD (past)
• Carli Willard, APRN

  • Family Nurse Practitioner
  • Enfield, CT
  • NPI 1972935211
  NPD (past)

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1861208217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 W STAFFORD RD STE 4A",
            "city": "STAFFORD SPRINGS",
            "state": "CT",
            "postal_code": "060761069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PALOMBA DR",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823888",
            "telephone_number": "860-951-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER BIRCH MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "IAN",
        "authorized_official_middle_name": "STERLING",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN OWNER",
        "authorized_official_telephone_number": "860-951-2198",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Shepard
• Amy Shepardson, RD, LDN
• Kelly A Shermer
• Shore Path Counseling LLC
• Sight Studio LLC
• Kristy Silvernail
• Karen J Simms
• Burl R Sindler
• Arthur H. Skalski, MD
• Matthew Skinner

• Family Medicine Physician in Enfield, CT
• Providers in Enfield, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.