Organization Active NPI

Avon Medical Professionals, LLC

  • Internal Medicine Physician
  • Avon, CT
National Provider Identifier
1902347222
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
AVON MEDICAL PROFESSIONALS, LLC
Practice address
36 E Main St
Avon, CT 06001-3801
Phone
(860) 677-5533
Fax
(860) 677-5862
NPI assigned
Mar 20, 2017
Last updated
Jul 24, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Authorized official

Name
Dr. Evan Schiff, MDNPI 1609853118
Title
Owner
Phone
(860) 677-5533

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
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

36 E Main St
Avon, CT 06001-3801

Mailing address

36 E Main St
Avon, CT 06001-3801
Phone (860) 677-5533

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041109001018 CT Part B Supplier - Clinic/Group Practice 8224091384 Receives reassigned benefits from 6 practitioners
Practice locations: Avon, 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
07D0092068Avon Medical Professionals, LLC36 East Main Street, Avon, CT 06001Certificate of waiverJun 29, 2027

National Provider Directory

National Provider Directory

Locations

36 E Main St
Avon, CT 06001
Phone (860) 674-0333

Practitioners & affiliated clinicians

Practitioners 6

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": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1902347222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 E MAIN ST",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013801",
            "telephone_number": "860-677-5533",
            "fax_number": "860-677-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 E MAIN ST",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013801",
            "telephone_number": "860-677-5533",
            "fax_number": "860-677-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVON MEDICAL PROFESSIONALS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "SCHIFF",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-677-5533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.