NPIMap

Organization Active NPI

Masonicare Primary Care Physicians

  • Geriatric Medicine (Internal Medicine) Physician
  • Wallingford, CT
National Provider Identifier
1922084540
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
MASONICARE PRIMARY CARE PHYSICIANS
Practice address
67 Masonic Avenue
1St Floor
Wallingford, CT 06492
Phone
(203) 265-0355
Fax
(203) 265-7413
NPI assigned
Dec 15, 2005
Last updated
Jan 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Authorized official

Name
Alla Bernshteyn, MDNPI 1063499507
Title
President
Phone
(203) 265-0355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

67 Masonic Avenue
1St Floor
Wallingford, CT 06492

Mailing address

67 Masonic Avenue
1St Floor
Wallingford, CT 06492
Phone (203) 265-0355

National Provider Directory

National Provider Directory

Locations

329 Main St
Ste 101
Wallingford, CT 06492

67 Masonic Ave
Ste 1100
Wallingford, CT 06492

329 Main St
Ste 110
Yalesville, CT 06492
Phone (203) 265-6677

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 152

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 152

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1922084540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MASONIC AVENUE",
            "address_2": "1ST FLOOR",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-265-0355",
            "fax_number": "203-265-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 MASONIC AVENUE",
            "address_2": "1ST FLOOR",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-265-0355",
            "fax_number": "203-265-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASONICARE PRIMARY CARE PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-15",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "BERNSHTEYN",
        "authorized_official_first_name": "ALLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-265-0355",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.