Individual provider Active NPI

Jorge Safar

  • Surgical Assistant
  • Farmington, CT
National Provider Identifier
1962869123
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
15-758 Issued in CT
Practice address
43 Fenwick Dr
Farmington, CT 06032-1450
Phone
(786) 781-5015
NPI assigned
Jan 19, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 15-758 CT Primary

Addresses

Primary practice location

43 Fenwick Dr
Farmington, CT 06032-1450

Mailing address

43 Fenwick Dr
Farmington, CT 06032-1450
Phone (786) 781-5015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15-758CTMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1962869123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 FENWICK DR",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321450",
            "telephone_number": "786-781-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 FENWICK DR",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321450",
            "telephone_number": "786-781-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFAR",
        "first_name": "JORGE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "CT",
            "license": "15-758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.