NPIMap

Organization Active NPI

Emergency Physicians of Connecticut PC

  • Emergency Medicine Physician
  • Waterbury, CT
National Provider Identifier
1902278906
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGENCY PHYSICIANS OF CONNECTICUT PC
Practice address
64 Robbins St
Waterbury, CT 06708-2613
Phone
(856) 686-4300
NPI assigned
Oct 29, 2015
Last updated
Dec 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Authorized official

Name
Robin Mouganis
Title
Pe Director
Phone
(856) 686-4394

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

64 Robbins St
Waterbury, CT 06708-2613

Mailing address

307 S Evergreen Ave
Woodbury, NJ 08096-2739
Phone (856) 686-4342

Other practice location 1

50 Hospital Hill Rd
Sharon, CT 06069-2096
Phone (860) 364-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151231000158 CT Part B Supplier - Clinic/Group Practice 8820390214 Receives reassigned benefits from 179 practitioners
Practice locations: Derby, CT; Waterbury, CT; Sharon, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 187

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.

View all 187

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1902278906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739",
            "telephone_number": "856-686-4342",
            "fax_number": "865-692-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 ROBBINS ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082613",
            "telephone_number": "856-686-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Hospital Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Sharon",
            "state": "CT",
            "postal_code": "060692096",
            "country_code": "US",
            "telephone_number": "860-364-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMERGENCY PHYSICIANS OF CONNECTICUT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "MOUGANIS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "PE DIRECTOR",
        "authorized_official_telephone_number": "856-686-4394"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.