Organization Active NPI

Naugatuck Valley Cardiovascular Associates

  • Cardiovascular Disease Physician
  • Middlebury, CT
National Provider Identifier
1881721900
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
NAUGATUCK VALLEY CARDIOVASCULAR ASSOCIATES
Practice address
1625 Straits Tpke
Suite 209
Middlebury, CT 06762-1836
Phone
(203) 758-9100
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Authorized official

Name
Dr. George Antonopoulos, MDNPI 1457419814
Title
Owner
Phone
(203) 758-9100

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
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X Primary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X 6868 CT

Addresses

Primary practice location

1625 Straits Tpke
Suite 209
Middlebury, CT 06762-1836

Mailing address

1625 Straits Tpke
Suite 209
Middlebury, CT 06762-1836
Phone (203) 758-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070620000102 CT Part B Supplier - Clinic/Group Practice 0244339059 Receives reassigned benefits from 5 practitioners
Practice locations: Middlebury, CT

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D1068716Naugatuck Valley Cardiovascular Assoc1625 Straits Tpke 209, Middlebury, CT 06762Certificate of waiverMay 17, 2027

National Provider Directory

National Provider Directory

Locations

1625 Straits Tpke
Ste 209
Middlebury, CT 06762
Phone (203) 758-9100

Practitioners & affiliated clinicians

Practitioners 6

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": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1881721900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TPKE",
            "address_2": "SUITE 209",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-758-9100",
            "fax_number": "203-758-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TPKE",
            "address_2": "SUITE 209",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-758-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAUGATUCK VALLEY CARDIOVASCULAR ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "ANTONOPOULOS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-758-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6868",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.