Active NPI
Shihab Masrur, M.D.
- Internal Medicine Physician
- Hartford, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 052284
- Practice address
- 80 Seymour Street
Hartford Hospital Cardiology Dept
Hartford, CT 06102-5037 - Phone
- (860) 972-4398
- NPI assigned
- Jul 30, 2009
- Last updated
- Aug 5, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 241713 | MA | |
| Internal Medicine Physician | 207R00000X | 052284 | CT | Primary |
Addresses
Primary practice location
80 Seymour Street
Hartford Hospital Cardiology Dept
Hartford, CT 06102-5037
Mailing address
PO Box 415933
Hartford Hospital Professional Services
Boston, MA 02241-5933
Phone (860) 545-7602
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001522846 | Medicaid | CT |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
18 Haynes St
Uppr Level
Manchester, CT 06040-4111
Phone (860) 649-7557
28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-5322
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 052284 | CT | MD | Internal Medicine Physician |
| 241713 | MA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Middlesex Hospital | Current | Accepting new patients | |
| Prospect CT Medical Foundation, Inc. | Internal Medicine | Current | Accepting new patients |
| Middlesex Hospital | Internal Medicine | Current | Accepting new patients |
| Alliance Medical Group of Greater Waterbury PC | Internal Medicine | Past | Accepting new patients |
Locations
1801 W Olympic Blvd
#2201
Pasadena, CA 91199
18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557
28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000
80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878
64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142
Interoperability endpoints
- smasrur85591@middlesexhealthprd.direct-ci.com
Organizations & group practices 4
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.
-
dba Middlesex Hospital dba Middlesex Hospital Physician Services
- Family Nurse Practitioner
- Middletown, CT
- NPI 1972563138
Internal Medicine
-
- Family Medicine Physician
- Manchester, CT
- NPI 1144677568
Internal Medicine
-
dba Middlesex Hospital Homecare and Hospice
- Community Based Hospice Care Agency
- Middletown, CT
- NPI 1003873233
-
- Internal Medicine Physician
- Middlebury, CT
- NPI 1750306015
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Middletown, CT
- NPI 1760454334
-
- General Acute Care Hospital
- Waterbury, CT
- NPI 1477902641
-
- General Acute Care Hospital
- Derby, CT
- NPI 1184639973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375660800000",
"number": "1861623431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415933",
"address_2": "HARTFORD HOSPITAL PROFESSIONAL SERVICES",
"city": "BOSTON",
"state": "MA",
"postal_code": "022415933",
"telephone_number": "860-545-7602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 SEYMOUR STREET",
"address_2": "HARTFORD HOSPITAL CARDIOLOGY DEPT",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061025037",
"telephone_number": "860-972-4398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASRUR",
"first_name": "SHIHAB",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-30",
"last_updated": "2013-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "241713",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "052284",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001522846",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.