Organization Active NPI

Stamford Primary Care, P.C.

  • General Practice Physician
  • Stamford, CT
National Provider Identifier
1881895324
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
STAMFORD PRIMARY CARE, P.C.
Practice address
1275 Summer Street
#107
Stamford, CT 06906
Phone
(203) 325-2667
Fax
(203) 973-0446
NPI assigned
May 31, 2007
Last updated
Sep 11, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Authorized official

Name
James Bivona, M.D.NPI 1063571560
Title
Owner
Phone
(203) 325-2667

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1275 Summer Street
#107
Stamford, CT 06906

Mailing address

1275 Summer Street
#107
Stamford, CT 06906
Phone (203) 324-9325

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091217000230 CT Part B Supplier - Clinic/Group Practice 1557446952 Receives reassigned benefits from 2 practitioners
Practice locations: Stamford, CT

National Provider Directory

National Provider Directory

Locations

1275 Summer St
Ste 105
Stamford, CT 06905
Phone (203) 325-2667

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1881895324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 SUMMER STREET",
            "address_2": "#107",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "06906",
            "telephone_number": "203-324-9325",
            "fax_number": "203-973-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 SUMMER STREET",
            "address_2": "#107",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "06906",
            "telephone_number": "203-325-2667",
            "fax_number": "203-973-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAMFORD PRIMARY CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "BIVONA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-325-2667",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.