Organization Active NPI

Lusitana Healthcare, LLC.

  • Primary Care Clinic/Center
  • Bridgeport, CT
National Provider Identifier
1962683219
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
044625 Issued in CT
Legal business name
LUSITANA HEALTHCARE, LLC.
Practice address
2660 Main St
Suite 205
Bridgeport, CT 06606-5369
Phone
(203) 334-2000
NPI assigned
Nov 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Authorized official

Name
Dr. Ana Maria Palhete, M.D.NPI 1912010158
Title
Owner
Phone
(203) 334-2000

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
Primary Care Clinic/Center 261QP2300X 044625 CT Primary

Addresses

Primary practice location

2660 Main St
Suite 205
Bridgeport, CT 06606-5369

Mailing address

2660 Main St
Suite 205
Bridgeport, CT 06606-5369
Phone (203) 334-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071212000432 CT Part B Supplier - Clinic/Group Practice 2961592126 Receives reassigned benefits from 1 practitioner
Practice locations: Bridgeport, CT

National Provider Directory

National Provider Directory

Locations

2660 Main St
Ste 205
Bridgeport, CT 06606
Phone (203) 334-2000

4699 Main St
Ste 102
Bridgeport, CT 06606
Phone (203) 334-2000

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1962683219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 MAIN ST",
            "address_2": "SUITE 205",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065369",
            "telephone_number": "203-334-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 MAIN ST",
            "address_2": "SUITE 205",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065369",
            "telephone_number": "203-334-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUSITANA HEALTHCARE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "PALHETE",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-334-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CT",
            "license": "044625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.