Individual provider Active NPI

Steven C Shifreen, MD

  • General Practice Physician
  • Hartford, CT
National Provider Identifier
1871663328
Registry record updated May 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
025728 Issued in CT
Practice address
645 Farmington Ave
Hartford, CT 06105
Phone
(860) 570-3400
Fax
(860) 570-0750
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 025728 CT Primary
Physical Therapist 225100000X 025728 CT

Addresses

Primary practice location

645 Farmington Ave
Hartford, CT 06105

Mailing address

645 Farmington Ave
Hartford, CT 06105
Phone (860) 570-3400

Other identifiers 1

IdentifierTypeStateIssuer
001257286MedicaidCT

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100429000327 CT Practitioner - General SurgeryPractitioner - Other (Physician)Practitioner - Pain Management 4385771070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
025728CTMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Musculoskeletal Medicine & Pain Management Associates, PC CurrentSince Jul 2, 2015 Accepting new patients

Locations

1224 Mill St
Bldg A
East Berlin, CT 06023
Phone (860) 570-3400

645 Farmington Ave
Hartford, CT 06105
Phone (860) 523-9788

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306108800000",
    "number": "1871663328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 FARMINGTON AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06105",
            "telephone_number": "860-570-3400",
            "fax_number": "860-570-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 FARMINGTON AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06105",
            "telephone_number": "860-570-3400",
            "fax_number": "860-570-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFREEN",
        "first_name": "STEVEN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2011-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CT",
            "license": "025728",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "025728",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001257286",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.