NPIMap

Organization Active NPI

Eastern Connecticut Surgical Care

  • Surgery Physician
  • New London, CT
National Provider Identifier
1861613010
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
027529 Issued in CT
Legal business name
EASTERN CONNECTICUT SURGICAL CARE
Practice address
4 Shaws Cove
Suite 201
New London, CT 06320
Phone
(860) 440-3070
Fax
(860) 444-7692
NPI assigned
May 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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

Authorized official

Name
Dr. Ronald E Clement, MDNPI 1407841786
Title
Owner
Phone
(860) 440-3070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 027529 CT
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 027529 CT Primary

Addresses

Primary practice location

4 Shaws Cove
Suite 201
New London, CT 06320

Mailing address

4 Shaws Cove
Suite 201
New London, CT 06320
Phone (860) 440-3070

Other identifiers 2

IdentifierTypeStateIssuer
004396033MedicaidCT
001275298MedicaidCT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1861613010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SHAWS COVE",
            "address_2": "SUITE 201",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "06320",
            "telephone_number": "860-440-3070",
            "fax_number": "860-444-7692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SHAWS COVE",
            "address_2": "SUITE 201",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "06320",
            "telephone_number": "860-440-3070",
            "fax_number": "860-444-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN CONNECTICUT SURGICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "CLEMENT",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-440-3070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CT",
            "license": "027529",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CT",
            "license": "027529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004396033",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001275298",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.