Organization Active NPI

CT Medical Group Inc.

  • Family Medicine Physician
  • East Haven, CT
National Provider Identifier
1962265934
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CT MEDICAL GROUP INC.
Practice address
317 Foxon Rd
East Haven, CT 06513-2038
Phone
(203) 529-3271
NPI assigned
Feb 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
Mr. Jasdeep Sidana, MDNPI 1558482075
Title
Officer/Owner
Phone
(646) 321-2626

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

317 Foxon Rd
East Haven, CT 06513-2038

Mailing address

317 Foxon Rd
East Haven, CT 06513-2038
Phone (203) 529-3271

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260324002275 CT Part B Supplier - Clinic/Group Practice 9739663105 Receives reassigned benefits from 36 practitioners
Practice locations: Orange, CT; Southington, CT; Stamford, CT; Stratford, CT; Waterbury, CT; Bridgeport, CT; West Hartford, CT; West Haven, 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
07D2111550CT Medical Group Inc - East Haven317 Foxon Rd, East Haven, CT 06513Certificate of waiverApr 10, 2028

National Provider Directory

National Provider Directory

Locations

317 Foxon Rd
East Haven, CT 06513
Phone (203) 484-9333

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1962265934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 FOXON RD",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065132038",
            "telephone_number": "203-529-3271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 FOXON RD",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065132038",
            "telephone_number": "203-529-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "SIDANA",
        "authorized_official_first_name": "JASDEEP",
        "authorized_official_title_or_position": "OFFICER/OWNER",
        "authorized_official_telephone_number": "646-321-2626",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.