Individual provider Active NPI

Vinod V Pathy, MD

  • Plastic Surgery Physician
  • Norwich, CT
National Provider Identifier
1922299098
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
045607 Issued in CT
Practice address
112 Lafayette St
Norwich, CT 06360-2737
Phone
(860) 425-8701
NPI assigned
Aug 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 045607 CT
Plastic Surgery Physician 208200000X 045607 CT Primary

Addresses

Primary practice location

112 Lafayette St
Norwich, CT 06360-2737

Mailing address

330 Washington St
Suite 410
Norwich, CT 06360-2700
Phone (860) 425-5300

Other identifiers 1

IdentifierTypeStateIssuer
010045607CT01OtherCTANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110809000544 CT Practitioner - Plastic and Reconstructive Surgery 4981798386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Temple University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Plastic Surgery Center LLCGroup PAC ID 1456665371, 3 clinicians

Practice addresses (Care Compare)

5 Davis Rd E
Old Lyme, CT 06371-1413
Phone (860) 390-6000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy18
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
045607CTMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Plastic Surgery Center LLC CurrentSince Jun 1, 2015 Accepting new patients
New England PA LLC CurrentSince Apr 17, 2019 Accepting new patients
New England Plastic Surgery Group, LLC PastSince Aug 1, 2012 Accepting new patients

Locations

5 Davis Rd E
Old Lyme, CT 06371
Phone (860) 390-6000

12 Halls Rd
Unit 878
Old Lyme, CT 06371

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1922299098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 WASHINGTON ST",
            "address_2": "SUITE 410",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602700",
            "telephone_number": "860-425-5300",
            "fax_number": "860-425-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LAFAYETTE ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602737",
            "telephone_number": "860-425-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHY",
        "first_name": "VINOD",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "045607",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CT",
            "license": "045607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "010045607CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.