Individual provider Active NPI

Gregory J Bombassei, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Avon, CT
National Provider Identifier
1962582718
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
032434 Issued in CT
Practice address
44 Dale Rd Ste 201
Avon, CT 06001-4351
Phone
(860) 679-0234
NPI assigned
Oct 16, 2006
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 032434 CT Primary

Addresses

Primary practice location

44 Dale Rd Ste 201
Avon, CT 06001-4351

Mailing address

44 Dale Rd Ste 201
Avon, CT 06001-4351

Other identifiers 3

IdentifierTypeStateIssuer
010032434CT07OtherCTANTHEM BC/BS OF CT
766507OtherCTCONNECTICARE
P2101979OtherCTOXFORD

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
I20050714000466 CT Practitioner - EndocrinologyPractitioner - Internal Medicine 2961438502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
University of Connecticut School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

44 Dale Rd
Suite 201
Avon, CT 06001-4351
Phone (860) 679-0234

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.36 of 100Reported as individual
Quality
96.8
Improvement activities
40
Cost
85.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032434CTMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth Endocrinology LLC Endocrinology, Diabetes & Metabolism CurrentSince Jun 7, 2004 Accepting new patients
Nuvance Health Medical Practice CT, Inc. Endocrinology, Diabetes & Metabolism Past Accepting new patients

Locations

40 Dale Rd
Ste 202
Avon, CT 06001
Phone (203) 931-0034

44 Dale Rd
Ste 201
Avon, CT 06001
Phone (860) 674-1713

Organizations & group practices 2

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 3

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1962582718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 DALE RD STE 201",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 DALE RD STE 201",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014351",
            "telephone_number": "860-679-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBASSEI",
        "first_name": "GREGORY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CT",
            "license": "032434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS OF CT",
            "identifier": "010032434CT07",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "766507",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2101979",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.